Page 66 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials
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Chapter 4
Materials and methods
A written study protocol was produced and registered on Prospero (CRD42015023689) before the initiation of the systematic review and meta- analysis. The data are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement(14).
Inclusion and exclusion criteria
The aim of the systematic review and meta-analysis was to evaluate published RCTs comparing techniques and materials for fascial closure of a laparotomy. The primary outcome was incisional hernia and the secondary outcomes were SSI, burst abdomen/wound dehiscence and suture sinus formation. A minimum of 12 months follow-up was required. All types of incisions (transverse/midline/ oblique/paramedian), all indications for surgery (both emergency and elective laparotomies) were included. Only human studies on adults > 18 years of age were included. Studies on mesh closure of laparotomies and studies including historic suture materials such as catgut and stainless steel sutures for comparison were excluded.
Search strategy
A systematic computerized search was done independently by two authors (NAH and FM) in the following databases: Medline, EMBASE, Cochrane, SCOPUS, CINAHL and Web-of-Science. The search was not restricted to certain languages or years of publication. The last search was performed the 9th of May 2016. In Medline and EMBASE, the search strategy was based on the Medical Subject Heading (MeSH) terms: laparotomy, wound closure, sutures and abdominal wall hernias. The detailed search term for Medline was ((“Wound Closure Techniques”[Mesh] OR “Sutures”[Mesh] OR “Surgical Procedures, Operative”[Mesh] AND “Laparotomy”[Mesh] AND (Randomized Controlled Trial[ptyp] AND “humans”[MeSH Terms])) OR (“Wound Closure Techniques”[Mesh] OR “Sutures”[Mesh] OR “Surgical Procedures, Operative”[Mesh] AND “Laparotomy”[Mesh] AND “Hernia, Ventral”[Mesh] AND (Randomized Controlled Trial[ptyp] AND “humans”[MeSH Terms]))).
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