Episode 9 - “Reinforced to Resist: A New Standard in Emergency Laparotomy – Redefining Closure with Mesh”
Update: 2025-05-04
Description
🎙️ Episode Title: “Reinforced by Evidence: Onlay Mesh to Prevent Fascial Dehiscence in Emergency Laparotomy”
Episode Description: In this episode, we explore the results of a landmark randomized clinical trial published in JACS, which evaluated the use of onlay prophylactic mesh reinforcement to prevent fascial dehiscence (FD) in high-risk patients undergoing emergency midline laparotomy.
Despite advances in closure techniques, FD remains a devastating complication—especially in emergent, contaminated scenarios. This study, conducted at Hospital das Clínicas, FMUSP, shows that reinforcement with onlay mesh reduced FD to 0%, compared to 13.5% in standard suture closures. While the mesh group experienced higher rates of minor surgical site occurrences (SSOs), over 90% were resolved with conservative or bedside management.
Join us as we break down:
🔹 The Rotterdam risk model as a tool for mesh indication
🔹 Technical considerations in mesh placement and tension distribution
🔹 The trade-offs between increased operative time and long-term outcomes
🔹 Why the use of mesh in contaminated fields may be safer than once thought
🧠 Take-Home Messages: • Prophylactic onlay mesh is safe and effective in FD prevention • Minor SSOs are acceptable when balanced against FD risk • Emergency surgical settings require tailored, evidence-based strategies
📢 This episode is available on all major streaming platforms and the Google Classroom of the Abdominal Wall and Content Group – HC-FMUSP.
Episode Description: In this episode, we explore the results of a landmark randomized clinical trial published in JACS, which evaluated the use of onlay prophylactic mesh reinforcement to prevent fascial dehiscence (FD) in high-risk patients undergoing emergency midline laparotomy.
Despite advances in closure techniques, FD remains a devastating complication—especially in emergent, contaminated scenarios. This study, conducted at Hospital das Clínicas, FMUSP, shows that reinforcement with onlay mesh reduced FD to 0%, compared to 13.5% in standard suture closures. While the mesh group experienced higher rates of minor surgical site occurrences (SSOs), over 90% were resolved with conservative or bedside management.
Join us as we break down:
🔹 The Rotterdam risk model as a tool for mesh indication
🔹 Technical considerations in mesh placement and tension distribution
🔹 The trade-offs between increased operative time and long-term outcomes
🔹 Why the use of mesh in contaminated fields may be safer than once thought
🧠 Take-Home Messages: • Prophylactic onlay mesh is safe and effective in FD prevention • Minor SSOs are acceptable when balanced against FD risk • Emergency surgical settings require tailored, evidence-based strategies
📢 This episode is available on all major streaming platforms and the Google Classroom of the Abdominal Wall and Content Group – HC-FMUSP.
Comments
In Channel
Download from Google Play
Download from App Store
United States00:00
00:00
x
