{"id":201,"date":"2019-09-27T09:00:32","date_gmt":"2019-09-27T09:00:32","guid":{"rendered":"http:\/\/www.barnaclinic.com\/blog\/patologia-pared-abdominal\/ca\/?p=201"},"modified":"2019-09-27T09:00:32","modified_gmt":"2019-09-27T09:00:32","slug":"infeccio-de-la-malla-quirurgica","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/patologia-pared-abdominal\/ca\/infeccio-de-la-malla-quirurgica\/","title":{"rendered":"Infecci\u00f3 de la malla quir\u00fargica en cirurgia de la paret abdominal"},"content":{"rendered":"

Els resultats que s’obtenen en la\u00a0reparaci\u00f3 d’una h\u00e8rnia<\/a>\u00a0o un\u00a0eventraci\u00f3 de la paret abdominal<\/a><\/strong>\u00a0s\u00f3n molt millors amb l’\u00fas de\u00a0malles quir\u00fargiques sint\u00e8tiques<\/strong>\u00a0(-plastias), que amb la sutura simple de l’orifici (-rafias).<\/span>\u00a0No obstant aix\u00f2, en tractar-se d’un material sint\u00e8tic col\u00b7locat en el cos que actua com un cos estrany, de vegades, poden provocar complicacions.<\/span>\u00a0Una d’aquestes complicacions \u00e9s la\u00a0infecci\u00f3 de\u00a0la malla quir\u00fargica<\/a><\/strong>\u00a0(2-3%).<\/span><\/p>\n

<\/p>\n

FACTORS DE RISC DE LA INFECCI\u00d3 DE LA MALLA QUIR\u00daRGICA<\/strong><\/span><\/h2>\n

Hi ha una s\u00e8rie de factors que fan m\u00e9s probable l’aparici\u00f3\u00a0d’infeccions de\u00a0la malla quir\u00fargica<\/a><\/strong>.<\/span>\u00a0Aquests factors depenen del pacient, de la malla o de la pr\u00f2pia cirurgia.<\/span>\u00a0Per aquest motiu, en major o menor grau, es poden prevenir.<\/span><\/p>\n

FACTORS DE RISC DEPENDENTS DEL PACIENT<\/strong><\/span><\/h2>\n

La\u00a0obesitat<\/a>\u00a0, el\u00a0tabac<\/a>\u00a0, la\u00a0diabetis<\/a>\u00a0i la immunosupressi\u00f3 s\u00f3n factors dependents del pacient que es relacionen amb m\u00e9s casos\u00a0d’infecci\u00f3 de\u00a0la malla quir\u00fargica<\/a><\/strong>\u00a0.<\/p>\n

QUINA MALLA QUIR\u00daRGICA UTILITZAR PER EVITAR INFECCIONS?<\/strong><\/span><\/h2>\n

El\u00a0tipus de malla quir\u00fargica<\/strong><\/a>\u00a0utilitzat pot influir directament en la possibilitat d’infecci\u00f3.<\/span>\u00a0\u00c9s preferible utilitzar una\u00a0malla quir\u00fargica<\/a><\/strong>\u00a0de porus ampli i reticular ja que les infeccions s\u00f3n m\u00e9s freq\u00fcents amb l’\u00fas de\u00a0malles microporoses<\/strong><\/a>\u00a0(laminars).<\/span>\u00a0Tamb\u00e9 \u00e9s com\u00fa la necessitat d’haver de retirar-les per a la seva curaci\u00f3.<\/span><\/p>\n

\n

\"\"<\/a><\/strong><\/h4>\n

“Per evitar casos d’infecci\u00f3 de la malla quir\u00fargica, es preferible utilizar malles de porus ampli i reticular”<\/h4>\n

Dr.\u00a0Juan Jos\u00e9 Espert<\/a><\/p><\/blockquote>\n

AMB QUINA CIRURGIA\u00a0HI HA M\u00c9S RISC D’INFECCI\u00d3 DE LA MALLA QUIR\u00daRGICA?<\/strong><\/span><\/h2>\n

Respecte a la intervenci\u00f3 quir\u00fargica, la\u00a0infecci\u00f3 de la malla quir\u00fargica<\/strong>\u00a0\u00e9s molt m\u00e9s freq\u00fcent en cirurgia d’urg\u00e8ncies, quan hi ha contacte amb el contingut intestinal (perforaci\u00f3, peritonitis, …) i quan la malla es col\u00b7loca m\u00e9s superficialment.<\/p>\n

CAUSA I S\u00cdMPTOMES DE LA INFECCI\u00d3 DE LA MALLA QUIR\u00daRGICA<\/strong><\/span><\/h2>\n

En la major part d’infeccions (m\u00e9s del 75%) el germen a\u00efllat \u00e9s un\u00a0Estafilococ<\/a>\u00a0(present en la pell del pacient de manera fisiol\u00f2gica.) Davant d’aquest tipus\u00a0d’infecci\u00f3 de la malla,<\/strong>\u00a0els s\u00edmptomes\u00a0acostumen ser: cel\u00b7lulitis, sortida persistent de l\u00edquid purulent per la pell (f\u00edstula) o l’aparici\u00f3 d’un absc\u00e9s.<\/p>\n

\n

\"\"<\/a><\/strong><\/h4>\n

“Els s\u00edmptomes d’infecci\u00f3 de la malla quir\u00fargica acostumen a ser:\u00a0\u00a0cel\u00b7lulitis, sortida persistent de l\u00edquid purulent per la pell (f\u00edstula) o l’aparici\u00f3 d’un absc\u00e9s”<\/h4>\n

Dr.\u00a0Juan Jos\u00e9 Espert<\/a><\/p><\/blockquote>\n

TRACTAMENT DE LA INFECCI\u00d3 DE LA MALLA QUIR\u00daRGICA<\/strong><\/span><\/h2>\n

El\u00a0tractament de la infecci\u00f3 de la malla quir\u00fargica<\/strong>\u00a0dep\u00e8n, sobretot, del moment de la infecci\u00f3.<\/p>\n

Tractament per a una infecci\u00f3 primerenca<\/strong><\/span><\/h5>\n

En cas d’una\u00a0infecci\u00f3 primerenca de la malla quir\u00fargica,<\/strong>\u00a0despr\u00e9s de la intervenci\u00f3, ha de ser conservador.<\/span>\u00a0\u00c9s a dir: drenatge, rentats de la ferida, antibi\u00f2tic i fins i tot ter\u00e0pia de buit (VAC) per intentar preservar la malla.<\/span><\/p>\n

Tractament per a la infecci\u00f3 cr\u00f2nica<\/strong><\/span><\/h5>\n

El tractament de la\u00a0infecci\u00f3 cr\u00f2nica de la malla quir\u00fargica<\/strong>\u00a0(m\u00e9s enll\u00e0 de 3-6 mesos), encara que no existeix un consens, \u00e9s la retirada completa de la malla infectada.<\/span>\u00a0Sempre tenint en compte les caracter\u00edstiques del pacient i la complexitat de la\u00a0reparaci\u00f3 de l’h\u00e8rnia<\/a>\u00a0o\u00a0l’eventraci\u00f3<\/a><\/strong>\u00a0.<\/span>\u00a0Cal tenir-ho en compte perqu\u00e8, amb la\u00a0retirada de la malla quir\u00fargica<\/strong>\u00a0infectada,<\/strong>\u00a0molt probablement reapareixer\u00e0 la mateixa\u00a0h\u00e8rnia<\/strong><\/a>\u00a0o\u00a0eventraci\u00f3<\/strong><\/a>\u00a0<\/span><\/p>\n

\n
\n

<\/p>\n

VOL CONTACTAR\u00a0AMB EL DR. JUAN JOS\u00c9 ESPERT?<\/span><\/h1>\n

DEMANAR CITA<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Els resultats que s’obtenen en la\u00a0reparaci\u00f3 d’una h\u00e8rnia\u00a0o un\u00a0eventraci\u00f3 de la paret abdominal\u00a0s\u00f3n molt millors amb l’\u00fas de\u00a0malles quir\u00fargiques sint\u00e8tiques\u00a0(-plastias), que amb la sutura simple de l’orifici (-rafias).\u00a0No obstant aix\u00f2, en tractar-se d’un material sint\u00e8tic col\u00b7locat en el cos que actua com un cos estrany, de vegades, poden provocar complicacions.\u00a0Una d’aquestes complicacions \u00e9s la\u00a0infecci\u00f3 de\u00a0la […]<\/p>\n","protected":false},"author":2,"featured_media":197,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59,69,60],"tags":[8,23,11,22,21,78,13],"yoast_head":"\nInfecci\u00f3 de la malla quir\u00fargica en cirurgia de la paret abdominal<\/title>\n<meta name=\"description\" content=\"La infecci\u00f3 de la malla quir\u00fargica sol ser m\u00e9s habitual en malles quir\u00fargiques 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