BACKGROUND: The incidence of incisional hernias (IHs) following midline abdominal incisions is difficult to estimate. Furthermore recent analyses have reported inconsistent findings on the superiority of absorbable versus non-absorbable sutures. OBJECTIVE: To estimate the mean @entity11126 rate following midline laparotomy from the published literature, to identify variables that predict @entity11126 rates and to analyse whether the type of suture (absorbable versus non-absorbable) affects @entity11126 rates. METHODS: We undertook a systematic review according to PRISMA guidelines. We sought randomised trials and observational studies including @entity1 undergoing midline incisions with standard suture closure. Papers describing two or more arms suitable for inclusion had data abstracted independently for each arm. RESULTS: Fifty-six papers, describing 83 separate groups comprising 14,618 @entity1 , met the inclusion criteria. The prevalence of IHs after midline incision was 12.8% (range: 0 to 35.6%) at a weighted mean of 23.7 months. The estimated risk of undergoing @entity11126 repair after midline laparotomy was 5.2%. Two meta-regression analyses (A and B) each identified seven characteristics associated with increased @entity11126 rate: one @entity1 variable (higher age), two surgical variables (surgery for AAA and either surgery for @entity28 surgery (model A) or using an upper midline incision (model B)), two inclusion criteria (including @entity1 with previous laparotomies and those with previous IHs), and two circumstantial variables (later year of publication and specifying an exact significance level). There was no significant difference in @entity11126 rate between absorbable and non-absorbable sutures either alone or in conjunction with either regression analysis. CONCLUSIONS: The @entity11126 rate estimated by pooling the published literature is 12.8% after about two years. Seven factors account for the large variation in @entity11126 rates across groups. However there is no evidence that suture type has an intrinsic effect on @entity11126 rates.

Systematic Review and Meta-Regression of Factors Affecting Midline Incisional Hernia Rates: Analysis of 14,618 XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity11126 :: ('MESH:C565524', 'Disease') :: ['IH'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity']
@entity1 :: (9606,Species) :: ['Patients']
