Prophylactic Reinforcement of Ventral Abdominal Incisions Trial

Inclusion Criteria:

1. Must be ≥ 18 years of age

2. Elective, open midline laparotomy ≥ 5 cm

3. Willing and able to provide written informed consent

4. Hernia risk equal to moderate or greater

Exclusion Criteria:

1. Previous hernia repair

2. Emergent surgery

3. Creation of skin flaps is preplanned

4. Preplanned 2nd surgery

5. Active skin pathology

6. Life expectancy less than 24 months

7. Pregnant or planning to become pregnant

8. Receiving a medication/medical condition that may adversely affect wound healing

9. ASA Class > IV

10. Enrolled in another clinical trial

11. Site personnel directly involved with this trial

12. Any condition that would preclude the use of the device or the subject formcompleting the follow-up requirements

13. Known or suspected allergy to tetracycline hydrochloride or kanamycin sulfate

14. Two separate incisions are created

15. Prior onlay mesh

16. Surgeon is unable to fully close the fascia

17. The surgery requires more than a single piece of mesh

18. Contraindication to placement of mesh

19. CDC Class IV/Active Infection

20. Breastfeeding