Using prophylactic biosynthetic mesh during ileostomy closure significantly reduces incisional hernia rates and healthcare costs.

• Hernia incidence dropped to 8% with mesh vs. 24% without (p = .029).
• Per-patient costs are €1,428.93 with mesh versus €2,290.00 without, saving €861.07.

Selective use in high-risk patients is recommended to optimize outcomes.

• Cumulative savings could reach €1.32 million for hospitals and €0.89 million for society annually with 25% mesh adoption.