ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Abstract

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

A Comparative Study of Elective Sublay Versus Onlay Repair for Non-complex, Small, and Medium-Size Incisional Hernia: Post-operative Complications in a Tertiary Hospital in Ranchi, India

“…Aseptic surgical field, healthy wound edge, using a suture-to-wound length ratio of 4:1 to maintain minimal tension in the suture line, using monofilament slowly absorbable suture material, and surgical technique (small stitches, small bites) are recommended for the prevention of incisional hernia [ 1 , 13 ].…”

Intercorrências de emergência que influenciam no prognóstico da laparotomia exploratória

“…Porém, a laparotomia mediana, por sua vez, é mais rápida e facilita o acesso a todos os órgãos intra-abdominais, por isso, em âmbito emergencial em pacientes com instabilidade hemodinâmica que requerem exploração, acaba sendo ainda a incisão de escolha. Deste modo, quando a patologia é claramente identificada, antes do ato cirúrgico e seu sítio bem delimitado, a incisão transversal pode ser uma boa opção na cirurgia mesmo que de emergência (FRASSINI et al, 2023).…”

Acute care nurses' experience in providing evidence‐based care for patients with laparotomy wounds: A scoping review

“…The available guidelines on laparotomies were developed for surgeons focused on intraoperative care, and not on the laparotomy wound management. 41 , 42 In general, acute care nurses were encouraged to refer to their local policies and procedures in their clinical settings in conjunction with general surgical wound guidelines 39 in caring for laparotomy wounds. The perspective of acute care nurses on barriers and enablers to providing EBC for patients with laparotomy wounds remains an area requiring research.…”