Jack C.J. Wereldsma, Cornelis M.A. Bruijninckx, Johannes Jeekel Abstract Background.
Incisional hernia is an important complication of abdominal surgery.
Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. Between March 1992 and February 1998, we performed a multicenter trial in which we randomly assigned to suture repair or mesh repair 200 patients who were scheduled to undergo repair of a primary hernia or a first recurrence of hernia at the site of a vertical midline incision of the abdomen of less than 6 cm in length or width. Recurrence rates and potential risk factors for recurrent incisional hernia were analyzed with the use of life-table methods. The size of the hernia did not affect the rate of recurrence. Among patients with midline abdominal incisional hernias, mesh repair is superior to suture repair with regard to the recurrence of hernia, regardless of the size of the hernia.