Experiences with a prophylactic mesh in 93 consecutive ostomies

World J Surg. 2010 Jul;34(7):1637-40. doi: 10.1007/s00268-010-0492-6.

Abstract

Background: Parastomal hernia may be present in half of patients after one year. A prophylactic low-weight prosthetic mesh in a sublay position at the index operation reduces the risk of parastomal hernia, without increasing the rate of complications.

Material: Between April 2003 and November 2006 all patients with an ostomy created at an open laparotomy were followed for at least one year.

Results: A prophylactic mesh was used in 75 of 93 patients. In 9 a prophylactic mesh could not be placed due to scarring after previous surgery. In 9 a mesh was omitted after surgeon's decision. In 19 patients a mesh was used in severely contaminated wounds. With a mesh 6 of 73 (8%) patients developed a surgical site infection and without a mesh 4 of 15 (27%). With a mesh parastomal hernia was present in 8 of 61 (13%) patients and without a mesh in 8 of 12 (67%).

Conclusions: Creating a stoma in routine open surgery a prophylactic mesh can be placed in most patients. A mesh does not increase the rate of complications and can be used in severely contaminated wounds.

MeSH terms

  • Aged
  • Female
  • Hernia / etiology*
  • Hernia / prevention & control
  • Humans
  • Laparotomy
  • Male
  • Middle Aged
  • Ostomy / adverse effects*
  • Postoperative Complications / prevention & control
  • Surgical Mesh*
  • Surgical Wound Infection / epidemiology
  • Suture Techniques