Consenso sobre condutas perioperatórias nas cirurgias de hérnias de parede abdominal utilizando o método Delphi em uma unidade pública de referência na cidade de Manaus

Abstract

Justification: Abdominal wall hernias are common surgical conditions that incur high hospital costs and significantly impact the socioeconomic lives of patients. Perioperative practices are traditionally transmitted empirically. Therefore, it is crucial to reassess and modernize the operational protocols employed, as various elements inherent to perioperative care require revision, especially following the emergence of protocols aimed at accelerating postoperative recovery. Objective: The objective is to develop a protocol for perioperative procedures for abdominal wall hernia repair surgeries in a public referral hospital located in the Northern region of Brazil, with specialist surgeons using the Delphi methodology. Method: This is a prospective study with a mixed-methods approach, both quantitative and qualitative, classified as methodological development. It aims to produce, analyze, and refine a consensus on perioperative practices for abdominal wall hernioplasties using the modified Delphi consensus method. The sample consisted of physicians with a residency in general surgery, possessing at least five years of experience and routine involvement in the treatment of abdominal wall hernias. The sample size was established by convenience, consisting of a panel of at least 20 specialist surgeons. Data were obtained through questionnaires administered in three stages to the participating group of specialists, addressing various aspects related to perioperative care for patients undergoing abdominal wall hernia repair surgeries. For data analysis, the Content Validation Index (CVI) was calculated to provide mathematical validation of the questions, based on the percentage agreement among participants, and Cronbach's Alpha coefficient was used to assess the internal consistency of the questionnaire, thus ensuring the quality and reliability of the collected data. Results: The study produced a protocol for perioperative clinical-surgical practices aimed at abdominal wall hernia repair surgeries. Conclusion: A socio-professional survey of the study participants was conducted, along with the development of a consensus among specialists. This process culminated in the production and publication of a protocol for perioperative clinical-surgical practices aimed at abdominal wall hernia repair surgeries.