Infección temprana de la malla quirúrgica en herniorrafia incisional. Incidencia, factores de riesgo y desenlaces en más de 60.000 pacientes

Autores/as

DOI:

https://doi.org/10.30944/20117582.1119

Palabras clave:

hernia incisional, herniorrafia, incidencia, factores de riesgo, complicaciones postoperatorias

Resumen

Introducción. La infección de la malla en cirugía de reparación de hernias de pared abdominal es un desenlace pobre, asociado a un incremento en el riesgo de complicaciones. El objetivo del presente estudio fue analizar la incidencia, los factores asociados y desenlaces en pacientes llevados a herniorrafia incisional con malla con posterior diagnóstico de infección temprana.

Métodos. Estudio de cohorte retrospectiva. Se utilizaron los datos de egresos hospitalarios de la National Inpatient Sample (NIS) de los Estados Unidos de América para identificar a todos los pacientes adultos llevados a herniorrafia incisional durante los años 2010 a 2015. Se utilizaron modelos de regresión logística bivariada y multivariada para evaluar los factores de riesgo en infección temprana de la malla, y finalmente, modelos de regresión logística y lineal, según el tipo de variable dependiente, de tipo stepwise forward para evaluar la asociación entre el diagnóstico de infección de malla y los desenlaces adversos.

Resultados. En total se incluyeron 63.925 pacientes. La incidencia de infección temprana de la malla fue de 0,59 %, encontrando como factores asociados: comorbilidades (obesidad, desnutrición proteico calórica, anemia carencial y depresión), factores clínico-quirúrgicos (adherencias peritoneales, resección intestinal, cirugía laparoscópica y complicaciones no infecciosas de la herida) y administrativos o asistenciales.

Conclusiones. La infección temprana, aunque infrecuente, se asocia con un aumento significativo en el riesgo de complicaciones. La optimización prequirúrgica con base en los factores de riesgo para este desenlace nefasto es un elemento clave para la reducción de la incidencia y mitigación del impacto de la infección en los pacientes con herniorrafía incisional con malla.

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Biografía del autor/a

Andrea Carolina Quiroga-Centeno, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, residente de Cirugía general.

Katherine Hoyos-Rizo, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, residente de Cirugía general.

Andrés Felipe Chaparro-Zaraza, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, residente de Cirugía general.

Pedro Felipe Pinilla-Merchán, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.

Médico general.

María Camila Pinilla Chávez, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, residente de Cirugía general.

Juan Paulo Serrano-Pastrana, Universidad Industrial de Santander, Bucaramanga, Colombia.

Médico, especialista en Cirugía general; jefe, departamento de Cirugía.

Sergio Alejandro Gómez Ochoa, Grupo de Estudios Epidemiológicos, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Médico, magíster en Bioinformática y bioestadística.

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Publicado

2022-02-03

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(1)
Quiroga-Centeno, A. C.; Hoyos-Rizo, K.; Chaparro-Zaraza, A. F.; Pinilla-Merchán, P. F.; Pinilla Chávez, M. C.; Serrano-Pastrana, J. P.; Gómez Ochoa, S. A. Infección Temprana De La Malla Quirúrgica En Herniorrafia Incisional. Incidencia, Factores De Riesgo Y Desenlaces En más De 60.000 Pacientes. Rev Colomb Cir 2022, 37, 194-205.

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