Profilaxis de la hernia incisional y utilización de mallas. Revisión narrativa

Hernández-Granados, Pilar; López-Cano, Manuel; Morales-Conde, Salvador; Muysoms, Filip; García-Alamino, Josep M; Rodríguez, José Antonio Pereira

doi:10.1016/j.ciresp.2018.01.003

Cited by 20 publications

(4 citation statements)

References 80 publications

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“…Prophylaxis strategies range from the modification of the surgical technique, as reported in the study by Lozada et al In 2016 [10], in which an abdominal wall reinforcement was performed with the RTL technique, reducing the presence of this complication from 20 to 4.5%. Most current studies are focused on the use of mesh prophylactically and report an overall incidence with its use of 9% [2,[4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…In patients at elevated risk for IH, prophylactic mesh implantation reduces the incidence of hernia formation, but with increased early postoperative pain and prolonged wound healing of surgical site infection [2,[4][5][6][7][8][9]. To maximize the benefit-risk ratio, despite technical modifications or prophylactic mesh implantation would ideally be performed in patients at elevated risk for hernia development.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Two Predictive Scores for the Development of Incisional Hernia

Hernández¹,

Gonzalez²,

Rodriguez³

et al. 2019

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Introduction: Incisional Hernia (IH) is a frequent complication of abdominal surgery, with an incidence of 10-23%, which can increase to 38% in specific risk groups. So far there is no ideal method to identify patients at high risk of developing IH, this variety in the criteria of inclusion of patients in different studies makes is very complicate to compare the results. The aim of this study is comparing the two predictive scores of incisional hernias (Hernia project Vs Van Ramshorst) with higher diagnostic performance and determine which is better to predict IH. Methods: An analytical, observational study was conducted between June and December 2018, in patients of both sexes, who were 18 years or older, undergoing midline laparotomy, regardless of their background diagnosis either urgently or scheduled between 2007 to 2016. The two different classifications, the Hernia Project score and Van Ramshorst score, were applied to each of the patients. With the identification of patients with hernia, two groups, healthy and ill, were performed and Bayesian statistics were made with it and to identify which scale best predicts the presence of this complication. Results: The records of 1085 patients undergoing midline laparotomy were reviewed. 296 patients were ruled out because their follow-up was not complete. Both tests were compared to determine the best diagnostic performance using the ROC curve and the area under the curve, finding that the Hernia Project Score has a larger area 0.724 compared to a 0.663 of Van Ramshorst. Discussion: In our patient cohort, the Hernia Project score has a greater predictive capacity, with an area under the best curve (0.72 vs. 0.66) however both They have a poor sensitivity and this is the main measure of the predictive capacity of any diagnostic test, so with these results, we can affirm that the Project hernia scale has a greater diagnostic capacity than the Van Ramshorst scale but still its diagnostic capacity is limited. Conclusions: Both scores have low sensitivity. We can affirm that the Hernia Project score has a greater diagnostic capacity than the Van Ramshorst score, but both have a limited diagnostic capacity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Two Predictive Scores for the Development of Incisional Hernia

Hernández¹,

Gonzalez²,

Rodriguez³

et al. 2019

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“…La hernia incisional (HI) se define como la pérdida de la integridad estructural de la pared músculo aponeurótica de la pared abdominal anterolateral que se desarrolla en cicatrices post operatorias (5,6) es la complicación más frecuente después de una laparotomía, más del 30% de pacientes sometidos a laparotomía presentarán hernia incisional, la mayoría ocurren dentro de los primeros 5 años posterior al procedimiento quirúrgico, incluso, con el uso métodos quirúrgicos óptimos (5,7) En Estados Unidos de Norte América se realizan cerca de 5 millones de laparotomías cada año y se estima que 30 al 50% desarrollarán HI (7,8) La reparación de la pared abdominal se puede realizar por vía laparoscópica o abierta, el defecto puede ser cerrado con puntos simples en ocho, con puntos continuos en grandes o pequeños bocados y con colocación de malla protésica cuando se trata de heridas limpias o limpias contaminadas (5,7,13).…”

Section: Discussionunclassified

Hernia incisional gigante en un adulto mayor

Vasquez-Santander,

Loaiza-Ramírez,

Velasco-García

et al. 2019

INSPILIP

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La hernia incisional (HI) figura dentro de las principales complicaciones posteriores a una laparotomía en los servicios de cirugía a nivel mundial, esta incidencia ha ido disminuyendo a través de los años principalmente debido al desarrollo de nuevas técnicas quirúrgicas, nuevos materiales de sutura y mallas protésicas, sin embargo, las hernias de gran tamaño aun representan un desafío para los especialistas cirujanos. Respecto a la clasificación de HI la evidencia recomienda utilizar la clasificación de la European hernia society (EHS). Al no existir un Gold standard diagnóstico, la TC proporciona el diagnóstico más sensible para HI seguido del ultrasonido y el examen físico. El abordaje quirúrgico en estos casos dependerá de un amplio abanico de factores, ya sean propios del paciente o de sus enfermedades concomitantes, así mismo las características del defecto aponeurótico, su tamaño, calidad de los tejidos, como también de factores relacionados con la destreza quirúrgica, y los recursos disponibles. Se presenta el caso de un paciente de 66 años, con diagnóstico de hernia incisional gigante de 8 meses de evolución posterior a laparotomía exploratoria, con obesidad grado I y diabetes mellitus tipo II, ingresó al servicio de cirugía del hospital José María Velasco Ibarra de la ciudad de Tena y bajo evaluación multidisciplinaria se decidió tratamiento quirúrgico mediante abordaje abierto, realizándose abdominoplastia y cirugía de reparación de hernia.

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“…The rate of incisional hernia after a laparotomy is up to 20% [1,2,3]. Therefore, it is a large economic burden, especially if a hernia recurrence occurs.…”

Section: Introductionmentioning

confidence: 99%

Biocellulose for Incisional Hernia Repair—An Experimental Pilot Study

et al. 2019

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Ventral or incisional hernia are a common disease pattern in general surgery. Mostcommonly, a mesh repair is used for reconstruction, whereby the mesh itself might causecomplications, like infections or adhesions. Biological materials, like biocellulose, might reducethese clinical problems substantially. In this prospective rodent study, a biocellulose mesh(produced by Gluconacetobacter xylinus) was implanted either by a sublay technique or assupplementation of the abdominal wall. After an observation period of 90 days, animals weresacrificed. The adhesions after the reconstruction of the abdominal wall were moderate. Thehistologic investigations revealed that the biocellulose itself was inert, with a minimal regenerativeresponse surrounding the mesh. The explanted mesh showed a minimal shrinkage (around 15%) aswell as a minimal loss of tear-out force, which might be without clinical relevance. This is the firstin vivo study describing biocellulose as a suitable mesh for the repair of ventral hernia in twodifferent hernia models. The material seems to be a promising option for solving actual problems inmodern hernia surgery.

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Profilaxis de la hernia incisional y utilización de mallas. Revisión narrativa

Cited by 20 publications

References 80 publications

Comparison of Two Predictive Scores for the Development of Incisional Hernia

Comparison of Two Predictive Scores for the Development of Incisional Hernia

Hernia incisional gigante en un adulto mayor

Biocellulose for Incisional Hernia Repair—An Experimental Pilot Study

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