Prophylactic Implantation of Biologic Mesh in Peritonitis (PROPHYBIOM): A Prospective Multicentric Randomized Controlled Trial
Background. Patients undergoing emergency surgery for peritonitis are at increased risk of abdominal wall-related complications. In patients with peritonitis the risk of incisional hernia (IH) is extremely elevated. The evaluation of quality of life of patients with incisional hernia showed lower mean scores on physical components of health-related quality of life and body image. Furthermore, the arise of a post-operative abdominal wall complication (i.e. wound dehiscence, evisceration and IH)
... reatly increases morbidity and mortality rates and prolongs the hospitalization.Methods. The present study aims to evaluate the efficacy of the use of a swine dermal collagen prosthesis implanted preperitoneally as a prophylactic procedure in urgency/emergency setting against abdominal wall complications in patients operated with contaminated/infected field in peritonitis. The sample size was defined in 90 patients divided in two arms (prosthesis positioning versus normal wall abdominal closure). The follow-up will be performed at 3, 6 and 12 months after surgery. The percentage of incisional hernias, wound infections, adverse events will be investigated by physical examination and ultrasound.Discussion. The objective is to evaluate the possibility to reduce the incisional hernia rate in patients undergoing urgent/emergent laparotomy in contaminated/infected field with peritonitis by using swine dermal collagen prosthesis preperitoneal positioning as a prophylactic procedure.Trial registration. The trial has been registered on clinicaltrials.gov (ID number: NCT04681326) from 23 December 2020.