Department of Surgery, Sundsvalls sjukhus, 851 86, Sundsvall, Sweden.
World J Surg. 2010 Jul;34(7):1637-40. doi: 10.1007/s00268-010-0492-6.
Parastomal hernia may be present in half of patients after one year. A prophylactic low-weight prosthetic mesh in a sublay position at the index operation reduces the risk of parastomal hernia, without increasing the rate of complications.
Between April 2003 and November 2006 all patients with an ostomy created at an open laparotomy were followed for at least one year.
A prophylactic mesh was used in 75 of 93 patients. In 9 a prophylactic mesh could not be placed due to scarring after previous surgery. In 9 a mesh was omitted after surgeon's decision. In 19 patients a mesh was used in severely contaminated wounds. With a mesh 6 of 73 (8%) patients developed a surgical site infection and without a mesh 4 of 15 (27%). With a mesh parastomal hernia was present in 8 of 61 (13%) patients and without a mesh in 8 of 12 (67%).
Creating a stoma in routine open surgery a prophylactic mesh can be placed in most patients. A mesh does not increase the rate of complications and can be used in severely contaminated wounds.
术后一年，约有一半的患者会出现造口旁疝。在初次手术中，预防性使用重量较轻的补片置于皮下，可以降低造口旁疝的风险，而不会增加并发症的发生率。
2003 年 4 月至 2006 年 11 月，所有接受剖腹开放式造口术的患者均进行了至少一年的随访。
75 例患者预防性使用了补片。9 例因既往手术瘢痕导致无法放置补片。9 例因外科医生的决定而未使用补片。19 例患者因严重污染的伤口使用了补片。使用补片的 73 例患者中有 6 例（8%）发生手术部位感染，而未使用补片的 15 例患者中有 4 例（27%）发生手术部位感染。使用补片的 61 例患者中有 8 例（13%）出现造口旁疝，而未使用补片的 12 例患者中有 8 例（67%）出现造口旁疝。
在常规开放性手术中创建造口时，大多数患者可以预防性使用补片。补片不会增加并发症的发生率，也可以用于严重污染的伤口。
