***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Incisional hernia is an important complication of abdominal surgery . Procedures for the repair of these hernias with sutures and with mesh have been reported , but there is no consensus about which type of procedure is best . METHODS Between March 1992 and February 1998 , we performed a multicenter trial in which we r and omly assigned to suture repair or mesh repair  200 patients who were scheduled to undergo repair of a primary hernia or a first recurrence of hernia at the site of a vertical midline incision of the abdomen of less than 6 cm in length or width . The patients were followed up by physical examination at 1 , 6 , 12 , 18 , 24 , and 36 months . Recurrence rates and potential risk factors for recurrent incisional hernia were analyzed with the use of life-table methods . RESULTS Among the 154 patients with primary hernias and the 27 patients with first-time recurrent hernias who were eligible for the study , 56 had recurrences during the follow-up period . The three-year cumulative rates of recurrence among patients who had suture repair and those who had mesh repair were 43 percent and 24 percent , respectively , with repair of a primary hernia ( P=0.02 ; difference , 19 percentage points ; 95 percent confidence interval , 3 to 35 percentage points ) . The recurrence rates were 58 percent and 20 percent with repair of a first recurrence of hernia ( P=0.10 ; difference , 38 percentage points ; 95 percent confidence interval , -1 to 78 percentage points ) . The risk factors for recurrence were suture repair , infection , prostatism ( in men ) , and previous surgery for abdominal aortic aneurysm . The size of the hernia did not affect the rate of recurrence . CONCLUSIONS Among patients with midline abdominal incisional hernias , mesh repair is superior to suture repair with regard to the recurrence of hernia , regardless of the size of the hernia Purpose The aim of this prospect i ve study was to present a 7-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and /or strangulated ventral hernias . Methods Patients with acutely incarcerated and /or strangulated ventral hernias were treated by emergency repair of the hernia using an onlay Prolene mesh . The presence of non-viable intestine necessitating resection-anastomosis of the bowel was not considered a contraindication to the use of mesh . Results The present study included 80 patients . Their age ranged from 25 to 86 years with a mean of 56.1 ± 13.2 years . The hernia was para-umbilical in 71 patients ( 88.75 % ) , epigastric in 6 patients ( 7.5 % ) and incisional in 3 patients ( 3.75 % ) . Eighteen patients ( 22.5 % ) had recurrent hernias . Resection-anastomosis of non-viable small intestine was performed in 18 patients ( 22.5 % ) . There were 2 perioperative mortalities ( 2.5 % ) . Complications were encountered in 17 patients ( 21.3 % ) and included wound sepsis in 9 patients ( 11.25 % ) , seroma formation in 5 patients ( 6.25 % ) , chest infection in 4 patients ( 5 % ) , deep vein thrombosis in 1 patient ( 1.25 % ) and mesh infection in another patient ( 1.25 % ) . Follow-up duration ranged from 12 to 84 months with a mean of 49.9 ± 19.9 months . Only one recurrence was encountered throughout the study period . Conclusions The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and /or strangulated ventral hernias is safe . The presence of non-viable intestine can not be regarded as a contraindication for prosthetic repair Background Incisional hernia is one of the most common late complications of open bariatric surgery . The aim of this study was to assess the safety and efficacy of preperitoneal prosthetic enforcement of midline incisions during open bariatric surgery in preventing incisional hernia development . Methods This study r and omized 64 morbidly obese patients admitted to undergo open bariatric surgery into two equal groups ( I and II ) . A prophylactic sheet of polypropylene mesh was fixed in the preperitoneal space during wound closure in group I while in group II the wound was closed conventionally . Results This study included 51females and 13 males ranged in age from 19 to 60 years . No significant difference was observed in mean age , mean preoperative body weight , mean body mass index , mean hospital stay , and mean follow-up period of either group . Three open procedures were done : vertical b and ed gastroplasty , Roux-en-Y gastric bypass , and vertical sleeve gastrectomy . No significant difference in mean operative time in either group for each operation was noted . Early postoperative wound complications were similar in either group . Incisional hernia incidence was significantly higher in group II , nine cases ( 28.1 % ) , than in group I , one case ( 3.1 % ) . Conclusions Using prophylactic preperitoneal Prolene mesh during wound closure in open bariatric surgery is safe and effective in preventing incisional hernia development Incisional hernia continues to be a serious postoperative complication in abdominal surgery . We present a prospect i ve r and omised study to evaluate the usefulness of placement of a supra-aponeurotic polypropylene mesh in the primary closure of laparotomies with a high risk of incisional hernia . Closure of a vertical laparotomy in 100 patients was accomplished with continuous suture using non-reabsorbable material , with placement of a polypropylene mesh on the aponeurotic surface in 50 patients . Three years after surgery , five patients in the group without the mesh had suffered incisional hernia . No incisional hernia was detected in the group in which closure was made using the mesh ( P=0.02 ) . Use of prosthetic material ( polypropylene mesh ) in the primary closure of laparotomies with a high risk of incisional hernia is useful for reduction of the rate of incisional hernias Objective : Our objective was to evaluate the safety and durability of biologic mesh for single-staged reconstruction of contaminated fields . Introduction : The presence of contamination during  ventral hernia repair ( VHR ) poses a significant challenge . Some advocate for a multistaged reconstructive approach with delayed definitive repair , whereas others perform definitive repair at the initial operation . Methods : Patients undergoing single-staged VHR in a contaminated field with biologic mesh over a 5-year period were retrospectively review ed from a prospect ively maintained data base . Outcome measures included wound complication and hernia recurrence . Results : A total of 128 patients ( 76 F , 52 M ) were identified , with a mean age of 58.2 years , mean American Society of Anesthesiologist ( ASA ) score 3.1 , and mean body mass index ( BMI ) 34.1 ± 9.7 kg/m2 . Comorbidities included COPD ( n = 29 ) , diabetes ( n = 65 ) , smoking ( n = 29 ) , and immunosuppression ( n = 8)  . Mean hernia defect size was 431 cm2 ( range 40–2450 cm2 ) . Reasons for contamination included the presence of infected mesh ( n = 45 ) , stoma ( n = 24 ) , concomitant gastrointestinal ( GI ) surgery ( n = 17 ) , enterocutaneous fistula ( n = 25 ) , open nonhealing wound(s ) ( n = 6 ) , enterotomy/colotomy ( n = 5 ) , and chronic draining sinus ( n = 6 ) . Postoperative wound complications were identified in 61 ( 47.7 % ) patients . Predictors of wound complications included ASA score , diabetes , smoking , number of previous abdominal surgeries or hernia repairs , hernia defect size , and operative time . With a mean follow-up time of 21.7 months , hernia recurrence was identified in 40 ( 31.3 % ) patients . The majority of recurrent hernias were asymptomatic and 7 patients underwent repair . Conclusions : Despite the high rate of wound morbidity associated with single-staged reconstruction of contaminated fields , it can safely be performed with biologic mesh reinforcement . Although biologic mesh in these situations is safe , the long-term durability seems to be less favorable Background The purpose of this study was to determine whether the prophylactic use of a biologic prosthesis protects against the development of incisional hernia in a high-risk patient population . Methods A prospect i ve , nonr and omized trial was conducted on 134 patients undergoing open Roux-en-Y gastric bypass by a single surgeon , at two institutions , from January 2005 to November 2007 . At Hospital A , all patients ( n = 59 ) underwent fascial closure of the abdominal midline wound with the prophylactic placement of a biologic mesh ( AlloDerm ® ) in an in-lay fashion . Patients at Hospital B ( n = 75 ) underwent primary abdominal wall closure using # 1 PDS in a running fashion . Data collected included patient demographics , abdominal wall closure technique , postoperative wound complications , follow-up period , and incidence of incisional hernia . Results During the study period 134 patients ( mean age = 40.4 years , 80.7 % female ) underwent open Roux-en-Y gastric bypass ( 59.7 % mesh , 41.5 % nonmesh ) . Twenty-eight patients were excluded from the analysis secondary to a short follow-up period ( mesh = 13 , nonmesh = 11 ) and /or reoperative surgery unrelated to the development of an incisional hernia ( mesh = 2 , nonmesh = 2 ) . The mean follow-up period was 17.3 ± 8.5 months . The overall incidence of incisional hernia was 11.3 % ( 95 % CI : 5.2–17.45 ) . The incidence of incisional hernia was significantly lower in the mesh group versus the nonmesh group ( 2.3 vs. 17.7 % , P = 0.014 ) . In a multivariate logistic regression model that adjusted for age , sex , body mass index , albumin , smoking , diabetes , prior surgery , seroma formation , weight loss , and mesh placement , the development of incisional hernia was found to be associated with smoking ( adjusted odds ratio [ OR ] 8.46 , 95 % CI : 1.79–40.00 , P = 0.007 ) while prophylactic mesh was noted to be protective against hernia development ( adjusted OR 0.06 , 95 % CI : 0.006–0.69 , P = 0.02 ) . Conclusion The prophylactic use of biologic mesh for abdominal wall closure appears to reduce the incidence of incisional hernia in patients with multiple risk factors for incisional hernia development OBJECTIVE To evaluate prospect ively long-term quality of life and functional outcome after  restorative proctocolectomy ( RPC ) with ileal pouch-anal anastomosis , and to evaluate and vali date a novel quality -of-life indicator in this group of patients . SUMMARY BACKGROUND DATA Restorative proctocolectomy with ileal pouch-anal anastomosis is now the preferred option when total proctocolectomy is required for ulcerative colitis or familial adenomatous polyposis , but long-term data on functional outcome and quality of life after the procedure are lacking . METHODS Patients ( n = 977 ) who underwent RPC with stapled anastomosis for colitis or polyposis coli and who were followed for > or = 12 months were included .  Quality of life , fecal incontinence , and satisfaction with surgery were prospect ively evaluated by structured interview or question naire for 1 to 12 years after surgery ( median 5.0 ) . Quality of life was scored using the Clevel and Global Quality of Life ( CGQL ) instrument ( Fazio Score ) . This is a novel score developed over the past 15 years by the senior author . Quality of life was also evaluated in a subgroup of patients with the Short Form 36 ( SF-36 ) . The CGQL was vali date d by determining its reliability , responsiveness , and validity as well as its correlation with the SF-36 score . RESULTS Postoperative quality of life as measured by SF-36 was excellent and compared well with published norms for the general U.S. population . The CGQL was found to be reliable , responsive , and valid , and there was a high correlation with the SF-36 scores . Using the CGQL , quality of life was shown to increase after the first 2 years after surgery , and there was no deterioration thereafter . The prevalence of perfect continence increased from 75.5 % before surgery to 82.4 % after surgery , and although this deteriorated somewhat > 2 years after surgery , it was no worse than preoperative values . Ninety-eight percent of patients would recommend the surgery to others . CONCLUSIONS Long-term quality of life after ileal pouch surgery is excellent and the level of continence is satisfactory . This surgery is an excellent long-term option in patients requiring total proctocolectomy . The CGQL is a simple , valid , and reliable measure of quality of life after pel 
    Output:
    
Conclusions The available evidence is limited , but does not support the superiority of biologic over synthetic non-absorbable prosthetics in contaminated fields