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2007, Number 4

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Rev Mex Cir Pediatr 2007; 14 (4)

Closure of massive abdominal wall with nonabsorbable suture material versus layered closure with absorbable suture materialin pediatric oncology patients. Cost Minimization Analysis

Lezama-del Valle P, Bracho-Blanchet E, Porras-Hernández JD, Carmona- Barba R, Nieto-Zermeño J, Sánchez-Losa FA

Language: Spanish
References: 35
Page: 170-184
PDF size: 367.49 Kb.


ABSTRACT

Background: Nowadays, the power to provide better quality treatment at less cost. Two recent meta-analysis have established that the mass closure technique with nonabsorbable suture material is the ideal form of abdominal wall closure in adult patients cancer and a study in female patients where cancer has not been able to show differences between ideal forms and materials for closure of the abdominal wall in pediatric oncology patients.
Objective: To establish the effectiveness of the closure of massive abdominal wall with nonabsorbable suture material compared with the traditional form of closure in layers with absorbable suture material in pediatric oncology patients at a lower cost without increasing the risks for patients about it. Hypothesis: The closure of the abdominal wall mass with non-absorbable suture material is less than or equal frequency of surgical site infection, wound dehiscence and hernia surgery postincisional that layered closure with absorbable sutures in pediatric oncology patients lower costs and shorter surgical closure.
Hypothesis: The closure of the abdominal wall mass with non-absorbable suture material is less than or equal frequency of surgical site infection, wound dehiscence and hernia surgery postincisional that layered closure with absorbable sutures in pediatric oncology patients lower costs and shorter surgical closure. Methods: Randomized controlled trial of patients younger than 18 years with a diagnosis of malignancy associated in any region of the body and surgically in the abdomen with open technique in the hospital. It will calculate the minimum number needed to treat and cost of the closure according to the group that owns the patient, number of sutures and surgical closure time employee.
Results: We included 23 patients randomized to 12 in the mass closure 11 with closure plans, with no significant differences in both groups, no difference was found regarding postoperative complications, hernias postincisionales, surgical wound infection or hernia, Sin But if you look close time decreased statistically significant (p = 0.025), so also in economic analysis cost less than half the mass closing costs, concluding that mass closure is more efficient than the closing levels since both methods are comparable but cheaper mass closure with nonabsorbable material.
Discussion: It has already demonstrated in multicenter studies that the mass closure with absorbable or nonabsorbable material is ideal for adult patients having no further studies reported in pediatric patients or pediatric cancer patients.
Our economic analysis found that the cost per patient is less mass closure for closing surgical time, finding no significant difference in the clinical course of patients. As important as it now if you plan to cost reduction in a hospital, the studies should evaluate are studies which show that a more effective method such as mass closure material nonabsorbable suture. In this study, costs were reduced surgical time and cost end of suture material, without being put at risk the patient’s prognosis. This way you can increase the productivity and effectiveness at a lower cost without worsening the patient’s prognosis.


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