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Sindrome compartimental abdominal .6
Estos problemas se solucionan con el empleo de distintos tipos de prótesis de cobertura, que incluyen desde una media de nylon hasta mallas prediseñadas como mallas absorbibles, mallas de Prolene y mallas de Silastic, con cierta preferencia por la primera, por su bajo costo y amplia disponibilidad. (7, 20. 22) Los materiales mencionados se usan por supuesto también en el tratamiento post descompresión del síndrome compartimental abdominal (SCA) en pacientes que previamente no se les había colocado en el acto operario como medida preventiva. (29, 36, 54, 69)
La figura 4 muestra el efecto de la reintervención sobre la hipertensión intraabdominal.
Figura 4: Comportamiento de la presión intraabdominal antes y después de la reintervención. (Tomado de una tesis para la terminación de residencias). (70)
En el Hospital Universitario “Dr. Juan Bruno Zayas Alfonso”, hemos realizado tesis de maestría acerca de la validación de la medición de la presión intraabdominal (a través de sondaje vesical) como índice de predicción de reintervención intraabdominal en pacientes portadores de abdomen agudo, mostrando esta sencilla prueba una sensibilidad y especificidad por encima de 90%. Este preceder es de uso cotidiano en todos los pacientes sometidos a cirugía abdominal ingresados en UTI de nuestro centro.
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