Damaris E. Navarro-Nuno, Rafael Arias-Moreno, Quitzia L. Torres-Salazar
Introduction: Incisional hernias are a common complication arising after midline laparotomy closure, and represent a signi?cant burden of morbidity and deterioration in patients' quality of life. Their incidence after laparotomy ranges from 2% to 20%, while that of abdominal dehiscence is between 1% and 3%. In patients considered to be at high risk, such as those who are overweight/obese, this complication can reach a worrying 35%. This makes it essential to seek strategies to prevent this type of complication. The aim of this study was to determine the ef?cacy of the small-bite closure technique in reducing the incidence of incisional hernia in obese patients. Methods: A prospective cohort study was performed, where 40 patients older than 18 years with BMI ≥ 25 who underwent elective or emergency laparotomy with midline incision and small-bites closure technique were included, who were followed up ultrasonographically for one year, to detect the presence or absence of incisional hernia. The sample size was calculated with a 95% con?dence level, a power of 80% and an expected frequency of 35% of incisional hernia development. Results: After a follow-up of 12 months we concluded with a total of 38 patients, with an age between 43 and 62 years, the most frequent sex was female. The most frequent reason for surgery was exploratory laparotomy (52.6%). Regarding nutritional status, 63% of the individuals were diagnosed as overweight and the remaining 37% as obese. The incidence of incisional hernia was 4 cases (10.5%) in 38 patients in a 12 months period. Conclusions: The use of the small-beat technique in midline surgery is effective in reducing the incidence of IH in overweight and obese patients, with zero frequency of surgical site infections, hematomas or dehiscence and a minimal percentage in the presence of seroma.
