P-016 INCISIONAL HERNIA AFTER ABDOMINAL EMERGENCY SURGERY. IMPACT OF PREVENTIVE SELF-ADHESIVE POLYESTER MESH PLACEMENT

Abstract

Abstract Objective Analyze the results of the self-adhesive polyester mesh placement in the prevention of the postoperative evisceration and incisional hernia after median abdominal incision during an emergency digestive surgery. Material and methods A prospective observational study was done in those patients who underwent a midline abdominal incision and a self-adhesive polyester mesh was placed in onlay position, for an emergency digestive surgery between December 2020 and December 2022. Analysis was done by means of demographics, body mass index (BMI), blood tests, ASA, P-Possum score, etiology, surgical contamination, abdominal incision closure, postoperative records (≥ 90 days) categorized with Clavien-Dindo (CD) classification and 1 year of follow-up. Results Sixty patients were included, mean age 62.86, (57.6% men), 52% were ASA III, BMI>30 12%. Most frequent etiologies were complicated small bowel obstruction (17) and complicated acute sigmoid diverticulitis (12). Postoperative records showed a 26,6% of morbidity, 93.7% were D I- II (minor) and 6.3% CD IIIb. Neither wound evisceration nor incisional hernia was observed during the follow-up. A significative relationship (p<0.05) was observed between BMI, preoperative C-reactive protein and ASA classification with postoperative complications, same relationship was observed between surgical contamination but without statistical significance. Conclusions In this series, a preventive self-adhesive polyester mesh placement after abdominal midline incision during emergency digestive surgery, showed an acceptable rate of postoperative complications with a low rate of local morbidity and a good results during the follow-up