Use of informed algorithm for patients selection of prophylactic mesh aplication after midline laparotomy in emergency surgery.
Midline laparotomy complications have a high rate. When midline laparotomy is performed complications rate is even higher. One of the commons complications is incisional hernia, reaching up to 40%- 50% of cases in High risk groups. Prophylactic mesh use has been proved to be useful preventing midline laparotomy in elective surgery. Despite this, there is not enough data to recommend its use in emergency surgery. Aim of the study is to investigate if use of an algorithm of informed decision for use of prophylactic mesh in emergency midline laparotomy reduces incisional hernia incidence. Prospective cohort study of all consecutive midline laparotomy performed at our emergency surgery department. Compare correct application of algorithm outcomes versus non correct application.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
100
Use of an algorithm for prophylactic mesh implantation in high risk patients after emergency midline laparotomy.
Hospital del Mar
Barcelona, Catalonia, Spain
RECRUITINGIncisional hernia
Diagnosis by clinical or image control of incicionsal hernia during follow up.
Time frame: Durign first and second year of follow up
Incidence os surgical site ocurrence complications
Any surgical site ocurrence (SSO) complication will be registered and classified using Clavien-Dindo complication scale. More common complications are: * Seroma: a localized accumulation of serous fluid in a part of the body, occurring most commonly as a complication of a surgical procedure. * Wound haemathoma: wound related swelling of blood. * Surgical site infection: infection that occurs after surgery in the part of the body where the surgery took place. Will be classified as superficial or deep infection. * Wound dehiscence: lack of cutaneous healing in surgical wound.
Time frame: During first postoperative month.
Long term mesh related complications: chronic pain and mesh infection.
Chronic pain: is any pain which persists beyond the normal healing period of 12 weeks. Visual analoge scale will be used to measure it. Mesh infection: Late-onset mesh infection is defined as acute inflammatory response in surgical area within months or years after operation. It is diagnosed by the presence of infection symptoms and imaging examinations.
Time frame: During first year of follow-up.
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