Utilidad del azul de metileno en la cirugía de la pared abdominal: 25 años de experiencia

Introduction: Methylene blue, has been used since the nineteenth century for the treatment of various diseases and also as a diagnostic aid in several situations. Its use for perioperative staining of the fistulous tracts and the affected areas of the prostheses with a chronic infection used in the repair of the abdominal wall is of great help. As far as we know, there is no article that collects this option. We demonstrate its usefulness today. Material and method: Throughout the surgical practice as surgeons specialized in abdominal wall, in the hospital, public and private, from 2000 to December 2017 we have collected 52 cases of chronic prosthesis infection with sinus and chronic suppuration in the skin of the abdominal wall of both primary hernias and eventrations; previously operated with placement of synthetic meshes of different materials. Results: In all the cases studied, methylene blue allowed us to recognize the infected synthetic material, as well as the surrounding tissues affected and the fistulous tract. In 60 % of the cases the prosthesis was in the supra aponeurotic space, it was made of polypropylene of different pore size and weight. Conclusion: The removal of the prosthetic material used in wall surgery to repair hernias and tissues with a chronic infection by a biolayer is the appropriate treatment to cure this complication. Methylene blue staining from the suppurative sinus on the skin is a simple and effective method that allows to identify the affected part and to resect it in its entirety.