OC-052 Study of incisional hernia as a result of patients with open abdomen management in a tertiary hospital

Abstract

Aim Open abdomen (OA) is a useful resource in critical situations, such as damage control surgery, abdominal sepsis, or compartment syndrome. However, it is not an innocuous technique with repercussions on the abdominal wall, for this reason, we have reviewed the results in our center. Material and Methods Retrospective descriptive study was carried out in a tertiary hospital between 2015–2022, all patients who required OA therapy were included. Results 92 patients (68 men, 24 women) were operated, with a mean age of 65 years, 65.3% were ASA 3–4. The most frequently system used was negative pressure therapy (NPT) (81 patients). 45 patients were closed without need replacement and 14 died before being performed. In the rest, the first TPN change was performed in 48–72 h, requiring a mean of 3.5 changes. Of the 78 patients underwent closure, 30 received primary fascial closure, 43 associated prophylactic mesh and other 5 only skin closure due to poor short-term prognosis. 24 patients died before discharge. 5 of the 30 patients with primary fascial closure had an incisional hernia. There were no hernias in the patients treated with prophylactic mesh but there was one case of chronic rejection. Conclusions OA is a useful resource; however, it is not exempt from short and long-term complications. At the time of definitive closure, it must be taken into account that these patients present multiple risk factors for the development of incisional hernias. For this reason, the use of prophylactic meshes in a protocolized manner is justified.