Dermolipectomía asociada al tratamiento quirúrgico de las hernias incisionales en pacientes obesos

Abstract

ObjetiveTo evaluate the results of the surgical treatment of ventral hernias in obese patients when a dermolipectomy is associated. Material and methodsA prospective series of cases was design. 61 obese patients with an incisional hernia were treated and a dermolipectomy was associated. The inclusion criteria were: patients with abdominal ventral hernia in the middline, at umbilical or infraumbilical area, with a hernia defect equal or higher than five centimeters, and patients with Body Mass Index higher than 30kg/m2. ResultsThe mean age was 49. All patients were female except three men. The mean body mass index was 33.3kg/m2. The hernia defect was higher than 10cm in 25 patients (40.98%), and between 5 and 10cm in 36 patients (59.01%). Mesh repair was performed by Rives technique in 58 (95.08%) cases and pre-aponeurotic procedure in 3 cases (4.91%). The morbidity of the series was 25.9% (18 patients): seromas in 6 patients (9.8%), bleeding 3 patients (4.9%), partial infection of the prosthesis in 1 patient (1.6%), partial necrotic lesions in the skin scar in 7 patients (11.4%) and recurrent hernia in 1 patient (1.6%). The mean days in hospital was 2.1. ConclusionsDermolipectomy associated to the ventral hernia repair in obese patients with umbilical or infraumbilical defects is an adequate alternative procedure that does not add considerable morbidity, may reduce recurrence rates and improve aesthetic results.