AB098. SOH25_AB_205. It’s time to consider wound bundles and prophylactic mesh placement in emergency abdominal surgery
General Surgery III

AB098. SOH25_AB_205. It’s time to consider wound bundles and prophylactic mesh placement in emergency abdominal surgery

Emily Kelly1, Angus Lloyd2, Daniah Alsaadi3, Ian Stephens4, Michael Sugrue2

1School of Medicine, College of Medicine, Nursing & Health Sciences, University of Galway, Galway, Ireland; 2Department of Surgery, Letterkenny University Hospital, Letterkenny, Ireland; 3Clinical Research Facility Galway, University Hospital Galway, Galway, Ireland; 4School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons Ireland, Dublin, Ireland

Background: Techniques optimizing laparotomy wound outcomes, such as wound bundles and prophylactic mesh placement (PMP), are used in less than 20% of emergency laparotomies due to a lack of awareness of their benefits and fear of mesh related complications. This study evaluates outcomes of wound bundles and resorbable synthetic PMP in emergency abdominal surgery.

Methods: A retrospective, consecutive, ethically approved study of patients undergoing emergency laparotomy using supplemental prophylactic onlay TIGR® Mesh at a university hospital between September 2017 and April 2024 was undertaken. Patient outcomes were assessed, and all patients were reviewed. Comprehensive wound bundles and subcutaneous space closure were used, and skin was closed with subcuticular sutures.

Results: A total of 49 patients (mean age 64 years) were included with a mean follow-up of 348 days. Thirty-three (67%) were female. The mean body mass index (BMI) was 27 kg/m2. Surgery was lower gastrointestinal in 67% and upper gastrointestinal in 8%. Surgery was contaminated or dirty in 41%. Approximately 20% had previous abdominal surgery. Postoperative complications occurred in 38%. Open abdomen was utilised in eight patients. Surgical site occurrences occurred in 9 (18%) patients. Superficial surgical site infections responded to antibiotics in four patients, and one required opening and negative pressure wound therapy. Incisional hernia developed in 3 patients (6%). There were no burst abdomens.

Conclusions: This study, using comprehensive wound bundles with onlay PMP, achieved excellent outcomes in high-risk emergency laparotomy patients, including those who required delayed abdominal wall closure, with low incisional hernia rate. Surgeons should consider incorporating these techniques into their practice.

Keywords: Emergency laparotomy; incisional hernia; prophylactic mesh; wound bundle; wound dehiscence

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab098
Cite this abstract as: Kelly E, Lloyd A, Alsaadi D, Stephens I, Sugrue M. AB098. SOH25_AB_205. It’s time to consider wound bundles and prophylactic mesh placement in emergency abdominal surgery. Mesentery Peritoneum 2025;9:AB098.

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