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Universitat Autònoma de Barcelona

1. Argudo Aguirre, Núria. Uso de malla profiláctica tras laparotomía en pacientes de riesgo.

Degree: Departament de Cirurgia, 2019, Universitat Autònoma de Barcelona

The study tries to deepen in different aspects of incisional hernia prophylaxis by means of the use of a synthetic prosthesis, such as its effectiveness in the prevention of this pathology, clinical implications and costs derived from the implementation of its use in a regulated way in a Department of General and Digestive Surgery. The central hypothesis of the project is based on the fact that the use of prophylactic mesh augmentation, in patients at high risk to develop an incisional hernia, can be a safe, effective and cost-effective measure for the prevention of this pathology. To answer this hypothesis, this thesis is composed of three articles published in indexed medical journals. These studies have been developed in the General Surgery Department of the Parc de Salut Mar (Barcelona), with patients treated in the fields of emergency and elective surgery for colorectal cancer resection. In the series analyzed in the first study, the incidence of incisional hernia after the closure of urgent midline laparotomy with continuous suture rises to 36%. With the placement of prophylactic mesh in these patients, we could see a dramatic impact on the incidence of hernia, with a decrease to 5.8%, without significantly increasing the morbidity or duration of hospital admission. The results of the second study indicate that prophylactic mesh placement is an effective measure for the prevention of HI in patients undergoing laparotomy for resection of colorectal cancer, without increasing morbidity. In the group of patients in whom the algorithm for prophylactic mesh augmentation was applied correctly, the incidence of HI fell to 10.2%. The use of the algorithm as a therapeutic decision tool proved its usefulness in all groups of patients. In obese patients, there is sufficient evidence to recommend prophylactic mesh augmentation as a preventive measure for HI. The implementation of the algorithm for the use of prophylactic mesh in selected patients reduced the incidence of HI and the total hospital cost per patient. According to our analysis, the need for repair of an incisional hernia leads to a substantial increase in total hospital costs and resource utilization. The results of our study show that not all patients benefit from the routine use of prophylactic mesh, but that it should be reserved for those patients at higher risk of developing HI, the rest can be safely closed following the most recent published recommendations. In the present study, there are several points of clinical interest that have led to a paradigm shift in the treatment given to the closure of laparotomies in our General Surgery Department. Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Pereira Rodríguez, José Antonio (director), Sancho Insenser, Joan Josep (director).

Subjects/Keywords: Hernia incisional; Incisional hernia; Malla; Mesh; Profilaxi; Profilaxis; Prevention; Ciències de la Salut; 617

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Argudo Aguirre, N. (2019). Uso de malla profiláctica tras laparotomía en pacientes de riesgo. (Thesis). Universitat Autònoma de Barcelona. Retrieved from http://hdl.handle.net/10803/667364

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Argudo Aguirre, Núria. “Uso de malla profiláctica tras laparotomía en pacientes de riesgo.” 2019. Thesis, Universitat Autònoma de Barcelona. Accessed December 05, 2019. http://hdl.handle.net/10803/667364.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Argudo Aguirre, Núria. “Uso de malla profiláctica tras laparotomía en pacientes de riesgo.” 2019. Web. 05 Dec 2019.

Vancouver:

Argudo Aguirre N. Uso de malla profiláctica tras laparotomía en pacientes de riesgo. [Internet] [Thesis]. Universitat Autònoma de Barcelona; 2019. [cited 2019 Dec 05]. Available from: http://hdl.handle.net/10803/667364.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Argudo Aguirre N. Uso de malla profiláctica tras laparotomía en pacientes de riesgo. [Thesis]. Universitat Autònoma de Barcelona; 2019. Available from: http://hdl.handle.net/10803/667364

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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