Manejo multidisciplinario de hernia abdominal compleja

Complex abdominal hernia is defined by specific criteria such as domain loss greater than 20%, defect greater than 10 cm, presence of contaminated or infected tissues, or multiple previous failed repairs. Its prevalence reaches 1.7% in the general population, increasing to 4% in people over 45 years of age, which underlines its clinical importance. The aim of this research was to analyze the scientific evidence available on the multidisciplinary management of complex abdominal hernia, including prehabilitation strategies and perioperative care. The methodology was based on a systematic bibliographic review using biomedical databases such as PubMed, Scopus, Google Scholar, Elsevier and SciELO, with specific search terms related to the multidisciplinary management of complex abdominal hernias. The results showed that prehabilitation with nutritional supplementation reaches a 97% adherence, significantly reducing hospital stay. The combination of botulinum toxin with preoperative progressive insufflation demonstrated success rates of 96.7% in fascial closure, with a recurrence of only 6.2% in medium-term follow-ups. It is concluded that the multidisciplinary approach, which integrates nutritional prehabilitation, respiratory physiotherapy and specific techniques such as botulinum toxin and PPP, significantly optimizes surgical results and reduces postoperative complications.