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Cirugía paraguaya

versión On-line ISSN 2307-0420

Resumen

CUENCA TORRES, Osmar; FERREIRA ACOSTA, Rosa  y  MARTINEZ, Nelson. TÉCNICA DE SEPARACIÓN DE COMPONENTES CON REFUERZO DE MALLA DE POLIPROPILENO PARA EL TRATAMIENTO DE AFECCIONES PARIETALES COMPLEJAS. NUESTRA EXPERIENCIA : TECHNIQUE FOR SEPARATION OF COMPONENTS WITH REINFORCEMENT OF POLYPROPYLENE MESH FOR THE TREATMENT OF COMPLEX PARIETAL CONDITIONS. OUR EXPERIENCE. Rev. Cir. Parag. [online]. 2015, vol.39, n.1, pp.17-21. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.2015.junio.17-21.

ABSTRACT Introduction: the technique of separation of components or technique of ramirez, in the separation of the anatomical components of the anterior abdominal wall, getting advances from 4 to 6 cm on each side of the edges of the defect with a lower tension locks in the treatment of complex wall conditions. Objective: to evaluate the results of complex parietal conditions with the technique of separation of components with polypropylene mesh reinforcement. Patients and methods: observational, descriptive, prospective, longitudinal in patients Electively, carriers of parietal complex condition, using the technique of separation of Componemtes reinforced polypropylene mesh, at the II Department of surgical clinic of the Hospital de Clínicas, Faculty of medical sciences of the National University of Asunción, in May 2010 to February of 2014. Results: 26 patients, 20 male and 6 female, mean age 52.6 años (22-83), the most frequent underlying pathologies were ischemic heart disease and Diabetes Mellitus Tuvimos19 patients with a history of surgery for faecal peritonitis with open abdomen closed by second intention, and 17 of them with stomata; 7 with hernias with loss of right of domicile, who held progressive pneumoperitoneum. The operative time was 270 min (180-360), carried out by specialists, we had complications (30.7%), cellulitis in 2 patients referring with antibiotic therapy, 2 cases of phlebitis that sagged with antibiotic therapy and local physical media, 2 patients with dehiscence of anastomosis (ileo-transverse and ileo-rectal), 1 patient with pneumonia who gave with antibiotic and 1 patient with wound treated with debridement, local necrosis. The time of internment average 18.5%) 10-27 days), we had two deaths, one by compartment syndrome and the other by abdominal sepsis. Follow-up of 24 months is no relapses. Conclusion: the technical separation of components with polypropylene mesh reinforcement is an effective technique and is a valid option in the repair of abdominal wall, patients with complex parietal disorders.

Palabras clave : separation of components; Technique; Parietal complex conditions.

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