EFETIVIDADE DAS ESTRATÉGIAS DE FECHAMENTO DE PAREDE ABDOMINAL NA PREVENÇÃO DE HÉRNIAS INCISIONAIS PÓS-LAPAROTOMIA
DOI:
https://doi.org/10.56238/levv16n55-094Palavras-chave:
Laparotomia, Hérnia Incisional, Fechamento Abdominal, Sutura, Revisão SistemáticaResumo
Introdução: As hérnias incisionais representam uma das complicações mais prevalentes e onerosas após laparotomias, com impacto relevante na morbidade pós-operatória e na qualidade de vida dos pacientes. Estratégias variadas de fechamento da parede abdominal vêm sendo estudadas com o objetivo de reduzir sua ocorrência. Objetivo: Avaliar a efetividade das técnicas de fechamento da parede abdominal na prevenção de hérnias incisionais após laparotomias, por meio de uma revisão sistemática da literatura. Método: Seguindo as diretrizes PRISMA 2020, foi realizada uma busca sistemática nas bases PubMed, Embase, Scopus, Cochrane Library e Web of Science. Foram incluídos ensaios clínicos, revisões sistemáticas e diretrizes que abordassem métodos de fechamento abdominal e seus desfechos relacionados à formação de hérnias. A avaliação da qualidade dos estudos foi conduzida com base nas ferramentas GRADE e SIGN. Resultados: Foram incluídos 52 estudos. Evidenciou-se que técnicas de sutura com pequenos pontos ("small bites"), o uso de fios triclosanados e a aplicação profilática de telas em pacientes de risco são as estratégias mais eficazes na redução da incidência de hérnias incisionais. Conclusão: O fechamento eficiente da parede abdominal deve considerar fatores técnicos, materiais utilizados e características individuais dos pacientes. A adoção de condutas baseadas em evidências é fundamental para otimizar os desfechos cirúrgicos e reduzir complicações tardias.
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