Synthetic Mesh for Prevention of HernIa After opEn Abdomen cLosure stuDy

Brief Summary

The aim of this clinical trial is to evaluate whether placement of a synthetic prophylactic onlay mesh during definitive fascial closure can reduce the incidence of incisional hernia in adult patients managed with an open abdomen approach following emergency surgery. The main questions it aims to answer are: * Does prophylactic mesh placement reduce the incidence of incisional hernia compared with fascial closure without mesh? * Does prophylactic mesh placement influence the occurrence of postoperative complications such as evisceration or surgical site infection? Researchers will compare patients undergoing definitive fascial closure with prophylactic mesh placement to those undergoing fascial closure without mesh in order to determine whether the mesh decreases the incidence of incisional hernia and associated complications. Participants will: * Undergo standard open abdomen management followed by definitive fascial closure. * Be randomly assigned to one of the two study groups: * Definitive fascial closure without prophylactic mesh. * Definitive fascial closure with placement of a synthetic prophylactic onlay mesh. * Attend clinical follow-up visits in the general surgery outpatient clinic. * Undergo clinical evaluations at 1, 6, and 12 months after surgery, including physical examination and, if necessary, imaging studies to detect incisional hernia or postoperative complications.

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