Background and rationale {6a}
loop ileostomies, abdominal pain, hernia, infections, SSI
SITE INFECTION, INFECTIONS, LEAKAGE
Diverting loop ileostomy is used in colorectal surgery to reduce the consequences of leakage of a bowel anastomosis. According to the Federal Statistical Office of Germany, approximately 15,000 diverting loop ileostomies and 11,500 loop ileostomy closures are performed annually in Germany [Multiple studies have shown that IH causes substantial morbidity and a reduction in the quality of life due to abdominal pain and discomfort, a reduction in the daily activity as well as mortality [Because of the important consequences for patients and national healthcare systems, the prevention of incisional hernia has been a subject of intensive investigation over the last decades. For ventral IHs, prophylactic mesh placement at the time of abdominal wall closure is now an accepted technique. Its efficacy has been tested in numerous randomised controlled trials (RCTs) [For ostomy reversal, much less evidence is available. Probably because concerns of safety have been voiced regarding an increased risk of surgical site infections (SSI) and mesh infections. Three non-randomised studies have been published on prophylactic mesh placement for ostomy reversal [In addition, one recent RCT trial (ROCSS, NCT02238964) compared prophylactic mesh placement in an intraperitoneal onlay position (IPOM) at the time of ostomy reversal to primary closure [