Abstract
BackgroundIncisional hernia is a common complication after liver transplantation with an incidence of 5 to 46%. Concerning non-transplant patients, a recently published meta-analysis describes a reduction of the incidence of incisional hernia of up to 85% due to prophylactic mesh replacement in elective, midline laparotomy. The aim of our study is to show a reduction of the incidence of incisional hernia after liver transplantation with minimal risk for complication.Methods/designThis is an unblinded, randomized controlled trial comparing time to incisional hernia over a period of 12 months between patients undergoing liver transplantation and standardized abdominal closure with or without prophylactic placement of Phasix™ (Bard – Davol Inc., Warwick, RI, USA) mesh in an onlay position. As we believe that the mesh intervention is superior to the standard procedure in reducing the incidence of hernia, this is a superiority trial.DiscussionThe high risk for developing incisional hernia following liver transplantation might be reduced by prophylactic mesh placement. Immunosuppressed patients are at high risk for developing surgical-site infections. We chose a mesh which has anti-inflammatory properties and is fully resorbed after 18 months.Trial registrationClinicalTrials.gov, ID: 03222102. Registered retrospectively on 17 July 2018. Protocol version 1.4, 7 October 2018.
Highlights
Incisional hernia is a common complication after liver transplantation with an incidence of 5 to 46%
The high risk for developing incisional hernia following liver transplantation might be reduced by prophylactic mesh placement
Aim of the study The aim of our study is to show a reduction in the incidence of incisional hernia after liver transplantation with minimal risks for complications
Summary
Incisional hernia is a common complication after liver transplantation with an incidence of 5 to 46%. Concerning non-transplant patients, a recently published meta-analysis describes a reduction of the incidence of incisional hernia of up to 85% due to prophylactic mesh replacement in elective, midline laparotomy. The aim of our study is to show a reduction of the incidence of incisional hernia after liver transplantation with minimal risk for complication. Artificial mesh is commonly used in ventral incisional hernia repair as described in the literature, but there is yet Concerning non-transplant patients, a recently published meta-analysis by Borab et al describes a reduction of the incidence of incisional hernia of up to 85% due to prophylactic mesh replacement in elective, midline laparotomy [14]. The mesh consists of suture material, which has proven reliability for many years and is characterized by an extremely long absorption rate of 12 to 18 months
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