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Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications
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Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications

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Are eviscerations preventable?

Julio Fernandes Tomasi1, Fabielle Menezes Tolfo2, Lais Madeira Constantino1

  • 1- Hospital São José, Serviço de Cirurgia Geral - Criciúma - SC - Brasil.

Revista Do Colegio Brasileiro De Cirurgioes
|February 26, 2025
PubMed
Summary

This study evaluated patients needing abdominal wall resuturing after evisceration. Results suggest prophylactic mesh use could prevent many eviscerations in high-risk patients.

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Area of Science:

  • Abdominal surgery
  • Surgical complications
  • Wound healing

Background:

  • Evisceration, a serious surgical complication, occurs in 3.5% of cases.
  • Prophylactic mesh use has been explored for high-risk patients.
  • Evaluating patient characteristics and prophylactic mesh benefits in evisceration cases is crucial.

Purpose of the Study:

  • To characterize patients undergoing abdominal wall resuturing due to evisceration.
  • To assess the potential benefit of prophylactic mesh in preventing evisceration.

Main Methods:

  • Retrospective cohort study of patients undergoing abdominal wall resuturing (2010-2023).
  • Inclusion: adult patients with median access surgery and index surgery at the same tertiary hospital.
  • Exclusion: pediatric patients, laparoscopic surgery, non-median access.
  • Utilized the modified Lima Rotterdam risk score for aponeurosis dehiscence.

Main Results:

  • Sample: 252 patients (74.2% male), median age 64 years, median BMI 24.3 kg/m².
  • Median time to resuturing: 8 days; median hemoglobin: 11.1 g/dL.
  • Comorbidities: 47.2% neoplasia, 32.1% smoking, 13% COPD; 58.8% elective surgeries.

Conclusions:

  • Applying the modified Rotterdam score to 227 patients indicated 72.2% (164 patients) were candidates for prophylactic mesh.
  • Prophylactic mesh could potentially prevent a significant number of eviscerations in this population.