Prophylactic Mesh Placement to Avoid Incisional Hernias after Stoma Reversal: A Prospective Randomized Study

Background: Incisional hernias are frequent complications following stoma reversal, often delaying recovery, especially in patients with chronic risk factors, including immunosuppression. Prophylactic mesh placement at the time of stoma closure has been proposed as a strategy to significantly reduce hernia occurrence, yet concerns about infection persist. Objectives: This study evaluates the efficacy and safety of prophylactic mesh placement during elective stoma reversal in reducing incisional hernia incidence. Methods: A prospective, randomized controlled trial was conducted in the Department of Surgery, LLRM Medical College, Meerut, from January 2023 to December 2024. Sixty patients undergoing elective stoma reversal were randomized: 30 received prophylactic mesh (Group A) and 30 underwent standard closure (Group B). Ethical approval was obtained; all patients provided informed consent. Outcomes included hernia incidence, surgical site infections (SSIs), complications, hospital stay, and follow-up. Results: Incisional hernias occurred in 3.3% of mesh patients and 16.7% of non-mesh patients. The mesh group experienced a slightly higher incidence of early wound infections (20%), but severe complications—such as mesh migration or infection—were rare and did not require mesh removal. Most infections were mild, managed conservatively. The mesh group had a marginally longer average hospital stay (13–15 days vs. 11–14 days), largely due to extended observation rather than complications. Conclusion: Prophylactic mesh placement in elective stoma reversal is a safe and effective means of reducing incisional hernia incidence, provided appropriate surgical technique and patient selection are applied. Further research with larger cohorts and longer follow-up is needed to confirm long-term durability and assess patientreported outcomes.