Aortic Aneurysm, Incisional Hernia
Conditions
Brief summary
The goal of this retrospective observational study is to evaluate whether prophylactic mesh reinforcement during abdominal wall closure can prevent incisional hernias (IH) in patients undergoing open abdominal aortic aneurysm (AAA) repair. The main questions it aims to answer are: * Does mesh reinforcement reduce the incidence of incisional hernias? * What is the frequency of associated postoperative complications? Researchers will compare the outcomes of patients who underwent mesh-reinforced closures to literature-reported outcomes for non-mesh cases to assess differences in IH incidence and complications. Participants will: * Undergo clinical follow-ups and abdominal ultrasounds to detect IH. * Complete quality-of-life questionnaires (EQ-5D and PROMIS).
Interventions
PROCEDUREProphylactic retromuscular mesh reinforcement
Prophylactic retromuscular mesh placement involves reinforcing the abdominal wall during closure after open abdominal aortic aneurysm (AAA) repair to prevent incisional hernias. This technique creates a retro-muscular space by carefully dissecting the rectus abdominis muscles from the posterior rectus sheath. A self-gripping polyester mesh or composite mesh is placed in this space, extending 4 cm beyond the midline on each side, ensuring tension-free coverage. The mesh is secured at key points, and the rectus sheaths are closed with continuous sutures. This approach leverages the anatomical integrity of the abdominal wall to reduce hernia risk without increasing postoperative complications.
Sponsors
Hôpital Fribourgeois
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adult patients (≥18 years old) who underwent open abdominal aortic aneurysm (AAA) repair with prophylactic retromuscular mesh reinforcement between January 2019 and January 2024 * Availability of complete medical records, including preoperative history, surgical details, and postoperative follow-up data * Attendance at a clinical follow-up examination at least one year after the procedure * General informed consent signed for the use of medical data for research purposes
Exclusion criteria
* Patients with incomplete or missing medical records, including preoperative, intraoperative, or follow-up data * Patients who required a re-laparotomy involving incision or suture of the prophylactic mesh and subsequently developed an incisional hernia. * Patients who did not attend the required clinical follow-up examination at least one year postoperatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of incisional hernias | january-april 2025 | Incisional hernia will be evaluated trough clinical examination and ultrasound assessement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of fascial dehiscence | january-april 2025 | Fascial dehiscence will be searched in the patient's records |
| Rate of seromas | january-april 2025 | will be searched in the patient's records |
| Rate of surgical site infection | january-april 2025 | will be searched in the patient's records |
| Rate of hematomas | january-april 2025 | will be searched in the patient's records |
| Operative time | january-april 2025 | will be searched in the operation protocols |
Countries
Switzerland
Contacts
Primary ContactRaffaella Sguinzi, PhD
Backup ContactMelissa Lagger
Outcome results
None listed