[Randomised study of the use resorbable mesh for the prevention of evisceration in colorectal surgery].
BACKGROUND
Evisceration is a complication that causes high morbidity and mortality, and its incidence in colorectal surgery varies between 2% and 3.5%. We evaluated the results of the use of resorbable meshes in the primary closure of laparotomies, with the purpose of preventing evisceration in colorectal surgery.


METHODS
One hundred and forty three patients were included (63 females/80 males) and divided in two groups: simple closed laparotomy (Group A) (72 patients) and closed with polyglycolic mesh (Group B) (73 patients), mean age 64 years (range 24-93). We evaluated: general and previous clinical data, as well as evisceration, infection, seroma and other acute complications after the surgery.


RESULTS
There were no differences between group distribution by general performances, associated pathology, clinical state and primary diagnosis. Most of Group B had programmed surgery (p = 0.045); mesh was used in 4 of 5 patients with faecal peritonitis, as expected drainage requirements were significant in Group B was needed significantly needed use drainages (Group A, 2.8%; Group B, 97.2%; p < 0.0005) and subsequent FNA after their withdrawal (p < 0.05). Overall incidence of evisceration was 3.5%, with Group A 5.6% and Group B 1.4%, with no significant differences. There were no differences in wounded infection.


CONCLUSIONS
This study has not been able to demonstrate that primary closure with mesh in these patients prevents evisceration, due to small sample size, and having a high incidence of seromas. Until further studies are carried out, its use should be reserved for selected cases, as it can be used in the presence of pus or faeces.
de la Portilla
Fernando
F
Unidad Clínica de Coloproctología, Hospital Juan Ramón Jiménez, Huelva, España. delaportilla@ucohuelva.com
Flikier
Benjamín
B
Espinosa
Eduardo
E
Utrera
Antonio
A
Rada
Ricardo
R
Vega
Juan
J
Cisneros
Nieves
N
Maldonado
Víctor Hugo
VH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery; D003627:Data Interpretation, Statistical; D004322:Drainage; D005260:Female; D006801:Humans; D015994:Incidence; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000517:prevention & control*; D049291:Seroma / Q000453:epidemiology / Q000517:prevention & control; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control
D011100:Polyglycolic Acid