Finding the best abdominal closure: An evidence-based review of the literature

Ceydeli, Adil; Rucinski, James; Wise, Leslie

doi:10.1016/j.cursur.2004.08.014

Cited by 133 publications

(99 citation statements)

References 43 publications

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“…Surgeons have been continuously striving to overcome postoperative complications associated with laparotomy wound closure using newer techniques and newer suture materials. Several reviews have studied the optimal suture repair for closing the abdominal fascia [4][5][6][7][8][9], but no consensus has been reached. In the present study, two types of suture materials were compared: Prolene®, a nonabsorbable polypropylene monofilament suture material, and Vicryl®, a synthetic delayed absorbable polyglactin 910 polyfilament suture material.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

Pandey

Singh

et al. 2012

Indian J Surg

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Wound dehiscence is a postoperative complication encountered following abdominal surgery. A prospective randomized study was conducted to compare the incidence of wound dehiscence with a delayed absorbable and a nonabsorbable suture material in the mass closure of vertical laparotomy wounds. In one group, 100 patients were analyzed after closure with Prolene®, and in another group, 100 patients were analyzed after closure with Vicryl®. The incision was closed by continuous far and near suture technique using polypropylene (Prolene) suture in one group and a synthetic delayed absorbable polyglactin 910 (Vicryl) suture in the other group. There was significant difference in the incidence of wound dehiscence between the two groups: 6 % with Prolene and 17 % with Vicryl, (χ 2 05.944, 1 DF, P value00.0148). The overall incidence of wound dehiscence was 11.5 % in this study. The incidence of wound dehiscence in both the study groups was higher than expected as compared to previous literature. There was a significant difference between the two suture materials. In our study, Prolene is a better suture material for closure of vertical laparotomy wounds.

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Section: Introductionmentioning

confidence: 99%

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

Pandey

Singh

et al. 2012

Indian J Surg

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“…Within the last decade the customary trend of using nonabsorbable sutures has changed, with numerous studies and meta-analyses advocating the use of slowly absorbable sutures, claiming comparable wound strength with significantly lower incidence of wound complications [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

An ideal suture for midline abdominal closure?

2009

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Background Within the last decade the customary trend of using non absorbable sutures has changed, with numerous studies and meta-analyses advocating the use of slowly absorbable sutures, claiming comparable wound strength with signifi cantly lower incidence of wound complications. It was the objective of this randomized clinical trial to compare two universally accepted suture materials, the non-absorbable Nylon and the slowly absorbable Polydioxanone for midline abdominal closure in the Indian context.

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“…Re-laparotomies and old incision length cause problems in wound healing and abdominal closure (26)(27)(28)(29)(30). In seven patients (10.9%) with a past surgery history and old abdominal incision scar, wound dehiscence and evisceration was observed in the early period.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

Yılmaz

Akıncı

Doğan

et al. 2013

UCD

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Objective: Post-laparotomy wound dehiscence, evantration and evisceration are important complications leading to an increase in both morbidity and mortality. Incisional hernias are frequently observed following abdominal surgeries and their occurrence is related to various local and systemic factors. This study aims to analyze the factors affecting wound healing by investigating the parameters that may cause wound dehiscence, incisional hernia, sinus formation and chronic incisional pain. Material and Methods:The records of 265 patients who underwent major abdominal surgery were analyzed. The data on patient characteristics, medication, surgical procedure type, type of suture and surgical instruments used and complications were recorded. The patients were followed up with respect to sinus formation, incisional hernia occurrence and presence of chronic incision pain. Statistical analysis was performed using SPSS 10.00 program. The groups were compared via chi-square tests. Significance was determined as p<0.05. Multi-variate analysis was done by forward logistic regression analysis.Results: 115 (43.4%) patients were female and 150 (56.6%) were male. Ninety-four (35.5%) patients were under 50 years old and 171 (64.5%) were older than 50 years. The median follow-up period was 28 months (0-48). Factors affecting wound dehiscence were found to be; creation of an ostomy (p=0.002), postoperative pulmonary problems (p=0.001) and wound infection (p=0.001). Factors leading to incisional hernia were; incision type (p=0.002), formation of an ostomy (p=0.002), postoperative bowel obstruction (p=0.027), postoperative pulmonary problems (p=0.017) and wound infection (p=0.011). Conclusion:Awareness of the factors causing wound dehiscence and incisional hernia in abdominal surgery, means of intervention to the risk factors and taking relevant measures may prevent complications. Surgical complications that occur in the postoperative period are especially related to wound healing problems.Key Words: Abdominal surgery, wound dehiscence, incisional hernia, sinus formation, chronic incisional pain INTRODUCTIONWound dehiscence after laparotomy can manifest with different presentations varying from simple skin detachment to evisceration and eventration, leading to an increase in surgical mortality and morbidity, as well as increase in length of hospital stay and loss of work force.Anterior abdominal wall incision hernia that can be seen in the long term is also one of the common surgical complications. Known as postoperative hernia or incisional hernia, it is thought to result from insufficient closure of the fascia and/or poor healing. Factors causing chronic or prolonged postoperative intra-abdominal pressure increase and those affecting wound healing contribute to its development. The incidence of incisional hernias vary from 2% to 20% in different sources, and in addition to pain and impairment in quality of life it may also cause significant complications (1, 2). It has been reported that incarceration may occur in a rate of 15%, ...

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Finding the best abdominal closure: An evidence-based review of the literature

Cited by 133 publications

References 43 publications

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

An ideal suture for midline abdominal closure?

A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development

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