Hernia prevention: practice patterns and surgeons’ attitudes about abdominal wall closure and the use of prophylactic mesh
The penetration of hernia prevention techniques into surgical practice remains unknown.
A survey about knowledge/attitudes on hernia prevention was sent to the members of hernia societies.
The 497 respondents were mostly from the US (47%) or Europe (40%). Most reported practicing, but not measuring their suture-to-wound length closure of > 4:1 (63%) and practicing but not measuring the number of stitches (58%). Reasons for not using short stitch closure were: does not apply to patient population (19%), not familiar enough with methods to correctly execute (25%), takes too long (13%), not reimbursed (4%), concerned about closure-related complications (27%), and other (22%). Regarding prophylactic mesh, respondents stated they were not familiar with literature (11%), familiar with literature but would not use (24%), familiar with literature and interested in use (45%), familiar with literature and using (15%), and other (5%).
There appears to be some application of hernia prevention principles related to fascial closure; however, the use of prophylactic mesh still appears to be controversial.
KeywordsHernia Prevention Prophylactic Mesh Laparotomy
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
Dr. Hope declares the following potential conflicts of interest not directly related to the submitted work: has consulted for CR Bard/Davol, served as a speaker for Bard, WL Gore and Intuitive Surgical, and has received research funding from Bard and Gore. Dr. Fischer declares the following potential conflicts of interest not directly related to the submitted work: has consulted for Bard, WL Gore, and Allergan. Dr. López-Cano declares the following potential conflicts of interest not directly related to the submitted work: has received consultant fees from Bard, WL Gore, and B. Braun. Dr. Harris declares no conflict of interest.
This study was deemed exempt by our Institutional Review Board.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained by all survey participants.
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