A randomized controlled study on patients underwent ileostomy closure with mesh reinforcement and its value in prevention of closure site incisional hernia.

Abstract

Stomal site incisional hernia is often an underestimated complication following ileostomy closure, with rates about 40%. This was because there were no sufficient previous studies undergone to find a definite solution for it. Therefore, the aim of this study was to evaluate the role of prophylactic mesh reinforcement (using a mesh manufactured from approximately equal parts of absorbable poliglecaprone monofilament fiber and non-absorbable polypropylene monofilament fiber) during ileostomy closure in prevention of stomal site incisional hernia without increasing the incidence of wound complications. This was a randomized controlled study done on 30 patients, 15 had mesh reinforcement during ileostomy closure (Group A) and the other 15 were control patients (Group B). The patients have undergone mesh reinforcement by placing the mesh over the rectus sheath after closing it by sutures and have been followed up for 6 - 24 months postoperatively for incidence of incisional hernia and wound infection. The results have shown that 2 of the patients who have undergone mesh reinforcement had incisional hernia (13.3%) while 7 of the other group had incisional hernia (46.7%) and 4 of the patients who have undergone mesh reinforcement had wound infection (26.6%) while 3 of the other group had wound infection (20%). Results of both groups were insignificantly different.