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Prevention of incisional hernias by prophylactic mesh-augmented reinforcement of midline laparotomies for abdominal aortic aneurysm treatment. Five-year follow-up of a randomized controlled trial.

Dewulf M, Muysoms F, Vierendeels T, Huyghe M, Miserez M, Ruppert M et al.

Ann Surg 2022; 276: e217-e222.

After five years, 67 patients were available for analysis by clinical examination. The rate of incisional hernias was 49.2% in the no mesh group versus none in the mesh group. Some 5/23 in the no mesh group required reoperation.

Comment: Prophylactic mesh remains controversial, but the evidence of benefit is increasing, and incisional hernia can be very debilitating in this patient group who tend to be elderly.

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