Outcomes following mesh reinforcement and primary suture repair for postoperative fascial dehiscence: A multicenter retrospective cohort study.

Authors

Rudolf van den Berg, Sophie van Streun, Sebastiaan van Steensel, Christel A L de Raaff, Pieter J Tanis, Eva B Deerenberg

Published in

Surgery. Pages 110500. Aug 03, 2026. Epub Aug 03, 2026.

Abstract

Fascial dehiscence, or burst abdomen, is a serious postoperative complication associated with high morbidity, prolonged hospitalization, and incisional hernia formation. The optimal repair strategy remains debated.
In this retrospective multicenter comparative cohort study, patients who underwent primary suture or mesh repair for fascial dehiscence within 14 days of their initial abdominal surgery between 2020 and 2023 were included. The composite primary outcome consisted of recurrent fascial dehiscence or incisional hernia within 1 year (re-fascial dehiscence/incisional hernia) and was evaluated using Kaplan-Meier and Cox-regression analyses.
Seventy-six patients with fascial dehiscence were included. Fascial dehiscence was repaired with suturing in 34 patients and reinforcement mesh in 42 patients. Median follow-up was 12 months (interquartile range, 4-23). Reoperation for re-fascial dehiscence was more frequent after suture repair (18% vs 2%, P = .022). Combined re-fascial dehiscence/incisional hernia occurred in 61% of sutured repairs versus 31% of mesh repairs (risk reduction by mesh reinforcement: hazard ratio, 0.37; 95% confidence interval, 0.17-0.78; P = .0097). Surgical complications within 1 year occurred in 27% after suture and in 5% after mesh repair (P = .009), with significant differences in Clavien-Dindo ≥IIIb events (12% vs 0%, P = .018). Fistula formation rates were 9% and 2% in the suture and mesh groups, respectively, with mesh-related infection occurring in 2% of cases. Hospital length of stay was median 22 days (interquartile range, 12-33) and 22 days (interquartile range, 13-31) in the suture and mesh groups, respectively (P = .836).
In this multicenter comparative cohort study, fascial dehiscence repair using mesh reinforcement was associated with a significantly lower risk of recurrent fascial dehiscence and incisional hernia development, and fewer complications.

PMID:
42722530
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.

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