ABSTRACT
INTRODUCTION: Prophylactic meshes in high-risk patients prevent incisional hernias, although there are still some concerns about the best layer to place them in, the type of fixation, the mesh material, the significance of the level of contamination, and surgical complications. We aimed to provide answers to these questions and information about how the implanted material behaves based on its visibility under magnetic resonance imaging (MRI). METHOD: This is a prospective multicentre observational cohort study. Preliminary results from the first 3 months are presented. We included general surgical patients who had at least two risk factors for developing an incisional hernia. Multivariate logistic regression was used. A polyvinylidene fluoride (PVDF) mesh loaded with iron particles was used in an onlay position. MRIs were performed 6 weeks after treatment. RESULTS: Between July 2016 and June 2022, 185 patients were enrolled in the study. Surgery was emergent in 30.3% of cases, contaminated in 10.7% and dirty in 11.8%. A total of 5.6% of cases had postoperative wound infections, with the requirement of stoma being the only significant risk factor (OR = 7.59, p = 0.03). The formation of a seroma at 6 weeks detected by MRI, was associated with body mass index (OR = 1.13, p = 0.02). CONCLUSIONS: The prophylactic use of onlay PVDF mesh in midline laparotomies in high-risk patients was safe and effective in the short term, regardless of the type of surgery or the level of contamination. MRI allowed us to detect asymptomatic seromas during the early process of integration. STUDY REGISTRATION: This protocol was registered at ClinicalTrials.gov (NCT03105895).
Subject(s)
Fluorocarbon Polymers , Incisional Hernia , Magnetic Resonance Imaging , Polyvinyls , Surgical Mesh , Adult , Aged , Female , Humans , Male , Middle Aged , Incisional Hernia/prevention & control , Prospective Studies , Risk Factors , Time Factors , Treatment Outcome , Young Adult , Aged, 80 and overABSTRACT
El bocio congénito es una patología infrecuente, que se genera por alteración de la función tiroidea fetal de causa endógena o exógena: disfunción tiroidea materna, déficit de aporte de yodo en la dieta o secundario a la toma de medicación. La repercusión en la maduración del feto, la compresión de estructuras adyacentes debido al aumento de tamaño, lo cual puede ser un factor de riesgo de obstrucción de la vía aérea y de lesiones hipóxico-isquémicas, hacen que el diagnóstico y tratamiento de esta patología sea de vital importancia. Habitualmente, se diagnostica por ecografía en el segundo o tercer trimestre de embarazo, pero la resonancia magnética (RM) se ha convertido en una técnica diagnóstica complementaria e importante ante un eventual tratamiento intraparto
Congenital goiter is an uncommon condition caused by altered fetal thyroid function of endogenous or exogenous cause (maternal thyroid dysfunction, iodine deficiency in the diet or secondary to taking medication). The impact on the mature development of the fetus, as well as the compression of adjacent structures due to increased size, which may be a risk factor for airway obstruction and hypoxic-ischemic lesions, make the diagnosis and treatment of this pathology of vital importance. It is usually diagnosed by ultrasound in the second or third trimester of pregnancy, but magnetic resonance imaging (MRI) has become a complementary and important diagnostic technique in the event of an intrapartum treatment procedure
