Preemer Trial - Prophylactic Mesh Versus no Mesh in the Midline Emergency Laparotomy Closure for Prevention of Incisional Hernia: a Multi Center, Double-blind, Randomized Controlled Trial

Inclusion Criteria: * Midline emergency laparotomy for any gastrointestinal indication Exclusion Criteria: * • Previous ventral hernia repair with mesh in the midline * Previous inguinal or femoral hernia repair by any technique with mesh is accepted * Previous WHO class of physical activity 3-4 (WHO 3 more than 50% of time at rest, WHO 4 stays at rest most of the time) * Relaparotomy * Indication for laparotomy is incarcerated hernia * Pregnant or suspected pregnancy * \<18 years * Metastastic malignancy of any origin * Planned osteomyelitis * Patients living geographically distant and/or unwilling to return for follow-ups * No informed consent * Subject participates in another RCT Intra-operative exclusion criteria applicable for both randomization groups * Abdomen is left open * Second look laparotomy planned * Ostomy created at the operation * Inability to keep the mesh securely out of the peritoneal cavity or close the anterior fascia * Intra-abdominal malignancy diagnosed at the operation * \>2 cm hernia in midline