A Multimodal Approach to the Prevention of Incisional Hernias After Midline Laparotomies in High-Risk Patients

This thesis is devoted to evaluating the effectiveness of a multimodal approach in the prevention of incisional hernias following midline laparotomies in high-risk patients. Obesity, diabetes mellitus, oncological diseases, nutritional deficiencies, and repeated surgical interventions reduce the mechanical stability of fascial closure and increase the risk of hernia development. Based on the analysis of scientific literature and clinical studies, the outcomes of prophylactic mesh implantation, the incidence of infectious complications, and its long-term effectiveness were investigated. The results demonstrated that prophylactic mesh augmentation significantly reduces fascial dehiscence and the formation of incisional hernias. The “small bites” technique, infection control measures, and risk stratification were identified as essential components of multimodal prevention. In conclusion, prophylactic mesh implantation represents an effective strategy within a personalized approach for patients belonging to high-risk groups.

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