<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992019000200105</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Técnica de &#8220;sándwich&#8221; o doble malla para la reparación de grandes defectos herniarios en el adulto mayor: revisión de una serie de casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Double mesh or &#8220;sandwich&#8221; technique applied to repair large hernias in the elderly: Case series report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valenzuela Alpuche]]></surname>
<given-names><![CDATA[Héctor Alí]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Country 2000 Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Guadalajara ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2019</year>
</pub-date>
<volume>41</volume>
<numero>2</numero>
<fpage>105</fpage>
<lpage>110</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992019000200105&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992019000200105&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992019000200105&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La técnica de doble malla es un recurso en pacientes con grandes defectos herniarios. El objetivo es describir nuestra experiencia en hernias recidivantes mayores de 10 cm o defectos múltiples en un grupo de pacientes mayores de 65 años.  Material y métodos:  Estudio retrospectivo y descriptivo de marzo de 2014 a marzo de 2018 de pacientes entre 65 y 83 años, con hernias mayores de 10 cm o defectos múltiples en pared abdominal que han recurrido, y que fueron operados con técnica de doble malla y separación de componentes. Se analizaron las siguientes variables: edad, género, tamaño del defecto, comorbilidades, complicaciones, estancia hospitalaria y recurrencia.  Resultados:  Se reunieron ocho pacientes, cinco mujeres y tres hombres de entre 65 y 83 años de edad, las comorbilidades asociadas fueron obesidad (IMC &gt; 30) en 80% de los casos, hipertensión arterial 62%, diabetes 50%, enfermedad coronaria 37.5%, enfermedad pulmonar obstructiva crónica 25% y ascitis 12%. Las complicaciones que se presentaron fueron seroma en cuatro pacientes (50%), dolor postoperatorio en un paciente (12.5%) e infección de herida quirúrgica superficial en un paciente (12.5%) y neumonía en un paciente (12.5%) La estancia hospitalaria promedio fue de dos a cuatro días. No hay recurrencia en ningún paciente hasta el momento.  Conclusiones:  La hernioplastía con doble malla es un recurso terapéutico eficaz y reproducible para pacientes con grandes o múltiples defectos recurrentes y con comorbilidades que los hacen propensos a recidiva.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  The double mesh technique is a great surgical resource for patients with large hernia defects. The objective of this study is to show our experience in the management of recurrent hernia defects larger than 10 cm in the elderly.  Material and methods:  A retrospective, descriptive study from March 2014 to March 2018 was conducted in patients ranging from 65 to 83 years old with recurrent hernia defects larger than 10 cm or multiple defects with previews failure of other attempts, operated with the double mesh surgical technique associated to anterior component separation in which the following variables where analyzed; Age, gender, defect size, comorbidities, surgical site occurrences, hospital stay and recurrence.  Results:  Eight patients were selected, five female and three male ranging from 65 to 83 years old. The most common comorbidities associated where in order of appearance Obesity (BMI &gt; 30) in 80% of the cases, high blood pressure 62%, diabetes 50%, heart conditions 37.5%, chronic obstructive pulmonary disease 25% and ascites 12%. Most common complications found where seroma in four patients (50%), postoperative pain one patient (12.5%) and superficial surgical site infection in one patient (12.5%), pneumonia one patient (12.5%). Average hospital stay was two to four days and no recurrence has been documented to this date.  Conclusions:  Hernia repair with double mesh technique is a reproducible and effective therapeutic resource for patients with large recurrent hernia defects in patients with comorbidities susceptible to hernia recurrence.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hernia incisional]]></kwd>
<kwd lng="es"><![CDATA[hernias gigantes]]></kwd>
<kwd lng="es"><![CDATA[hernioplastía incisional]]></kwd>
<kwd lng="es"><![CDATA[técnica de &#8220;sándwich&#8221;]]></kwd>
<kwd lng="es"><![CDATA[material protésico]]></kwd>
<kwd lng="es"><![CDATA[complicaciones]]></kwd>
<kwd lng="en"><![CDATA[Incisional hernia]]></kwd>
<kwd lng="en"><![CDATA[giant hernia]]></kwd>
<kwd lng="en"><![CDATA[incisional hernioplasty]]></kwd>
<kwd lng="en"><![CDATA[double mesh technique]]></kwd>
<kwd lng="en"><![CDATA[prosthetic mesh]]></kwd>
<kwd lng="en"><![CDATA[complications]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caglià]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Tracia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Borzì]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Amodeo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Tracia]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Veroux]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incisional hernia in the elderly. Risk factors and clinical considerations]]></article-title>
<source><![CDATA[Int J Surg]]></source>
<year>2014</year>
<volume>12</volume>
<page-range>S164-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Le Huu Nho]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mege]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ouaissi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sielezneff]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Sastre]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence and prevention of ventral incisional hernia]]></article-title>
<source><![CDATA[J Visc Surg]]></source>
<year>2012</year>
<volume>149</volume>
<page-range>e3-14</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martín-Cartes]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Tamayo-López]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bustos-Jiménez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;Sandwich&#8221; technique in the treatment of large and complex incisional hernias]]></article-title>
<source><![CDATA[ANZ J Surg]]></source>
<year>2016</year>
<volume>86</volume>
<page-range>343-7</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chevrel]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Rath]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Classification of incisional hernias of the abdominal wall]]></article-title>
<source><![CDATA[Hernia]]></source>
<year>2000</year>
<volume>4</volume>
<page-range>7-11</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Awad]]></surname>
<given-names><![CDATA[ZT]]></given-names>
</name>
<name>
<surname><![CDATA[Puri]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[LeBlanc]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Stoppa]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Fitzgibbons]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Iqbal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mechanisms of ventral hernia recurrence after mesh repair and a new proposed classification]]></article-title>
<source><![CDATA[J Am Coll Surg]]></source>
<year>2005</year>
<volume>201</volume>
<page-range>132-40</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hicks]]></surname>
<given-names><![CDATA[CW]]></given-names>
</name>
<name>
<surname><![CDATA[Poruk]]></surname>
<given-names><![CDATA[KE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term outcomes of sandwich ventral hernia repair paired with hybrid vacuum-assisted closure]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2016</year>
<volume>204</volume>
<page-range>282-7</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mayagoitia]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Cisneros]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
<name>
<surname><![CDATA[Rafal]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Técnica de Rives para hernia incisional. Análisis de 218 casos]]></article-title>
<source><![CDATA[Cir Gral]]></source>
<year>2012</year>
<volume>34</volume>
<page-range>25-31</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Klinge]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Krones]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Can we be sure that the meshes do improve the recurrence rates?]]></article-title>
<source><![CDATA[Hernia]]></source>
<year>2005</year>
<volume>9</volume>
<page-range>1-2</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ibarra-Hurtado]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Nuño-Guzmán]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Echegaray-Herrera]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Robles Vélez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[De Jesús González-Jaime]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of botulinum toxin type A before abdominal all reconstruction]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>2009</year>
<volume>33</volume>
<page-range>2553-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matapurkar]]></surname>
<given-names><![CDATA[BG]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Agarwal]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A new technique of &#8220;Marlex-peritoneal sandwich&#8221; in the repair of large incisional hernias]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>1991</year>
<volume>15</volume>
<page-range>768-70</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moreno-Egea]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La técnica de la doble reparación protésica (según Moreno-Egea) como solución en el caso de hernias subcostales masivas]]></article-title>
<source><![CDATA[Rev Hispanoam Hernia]]></source>
<year>2014</year>
<volume>2</volume>
<page-range>1-2</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carbonell-Tatay]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno-Egea]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[García-Pastor]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Vergara-Suárez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Iserte-Hernández]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bonafé]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo quirúrgico de las eventraciones suprapúbicas: experiencia con la técnica de doble malla en 53 casos consecutivos]]></article-title>
<source><![CDATA[Rev Hispanoam Hernia]]></source>
<year>2014</year>
<volume>2</volume>
<page-range>3-8</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
