O03 SMALL BITES AND PROPHYLACTIC MESH TO PREVENT INCISIONAL HERNIA IN HIGH-RISK PATIENTS. A MESH IS THE MOST POWERFUL TOOL

Autor:	Miguel Pera Román, A. Bravo-Salva, Jose Antonio Pereira-Rodriguez, Sara Amador, Juan José Sancho Insenser, Manuel López Cano, Blanca Ventura-Montcusí
Rok vydání:	2021
Předmět:	medicine.medical_specialty High risk patients business.industry Incisional hernia Medicine Surgery business medicine.disease
Zdroj:	British Journal of Surgery. 108
ISSN:	1365-2168 0007-1323
DOI:	10.1093/bjs/znab396.002
Popis:	Aim Small bites (SB) technique for closure of elective midline laparotomies (EMLs) and a prophylactic mesh (PM) in high-risk patients are suggested by guidelines to prevent incisional hernias (IHs) and burst abdomen (BA). Our aim was to implement a protocol combining both and to analyze its outcomes. Material and Methods Prospective data collection of all EMLs for one year. Results were analyzed at one month and during follow-up. The incidence of IH and BA was compared by groups depending on the use of a PM (M Group) or not (S Group), and in subgroups related to the closure technique: SB (Subgroups MSB and SSB) or not (Subgroups MLB and MSB). Results A lower number of BA was diagnosed in the M group (OR 0.0692; CI95% 0.008-0.56; P = 0.01) in 197 operations. 163 patients completed a mean follow-up of 29.23 months, with a lower frequency of IH in M group patients (OR = 0.769; CI 95% 0.65 - 0.91; P Conclusions A PM is the most powerful tool for prevention both IH and BA after EMLs, regardless of the closure technique in patients at high-risk for IHs.
Databáze:	OpenAIRE
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