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The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations

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Název: The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations
Autoři: M. Golling, V. Breul, Z. Zielska, P. Baumann
Zdroj: Hernia
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Laparotomy, Sutures, Abdominal Wall, Suture Techniques, Abdominal Wound Closure Techniques, 1 suture -/wound length (SL/WL) ratio, Abdominal Wound Closure Techniques [MeSH], Laparotomy/adverse effects [MeSH], Suture Techniques [MeSH], Median/midline and transverse incision [Abdominal Wall/surgery [MeSH], Female [MeSH], Abdominal Muscles/surgery [MeSH], Laparotomy/methods [MeSH], Herniorrhaphy [MeSH], Human cohort study, Humans [MeSH], Prospective Studies [MeSH], Non randomized, Sutures [MeSH], Cohort Studies [MeSH], Controlled trial, Original Article, Fascial closure technique, Male [MeSH], Elective and emergency surgery, Small bites, Short stitches, 6], Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Humans, Female, Prospective Studies, Herniorrhaphy, Abdominal Muscles
Popis: Aim To analyze laparotomy closure quality (suture/wound length ratio; SL/WL) and short term complications (surgical site occurrence; SSO) of conventional midline and transverse abdominal incisions in elective and emergency laparotomies with a longterm, absorbent, elastic suture material. Method Prospective, monocentric, non-randomized, controlled cohort study on short stitches with a longterm resorbable, elastic suture (poly-4-hydroxybutyrate, [p-4OHB]) aiming at a 6:1 SL/WL-ratio in midline and transverse, primary and secondary laparotomies for elective and emergency surgeries. Results We included 351 patients (♂: 208; ♀: 143) with midline (n = 194), transverse (n = 103), and a combined midline/transverse L-shaped (n = 54) incisions. There was no quality difference in short stitches between elective (n = 296) and emergency (n = 55) operations. Average SL/WL-ratio was significantly higher for midline than transverse incisions (6.62 ± 2.5 vs 4.3 ± 1.51, p p Clinically, superficial surgical site infections (SSI, CDC-A1/2) were encountered in 8%, while 4,3% were related to intraabdominal complications (CDC-A3). An abdominal wall dehiscence (AWD) occurred in 22/351 patients (6,3%)—twice as common in emergency than elective surgery (12,7 vs 5,1%)—necessitating an abdominal revision in 86,3% of cases. Conclusion We could show that a short stitch 6:1 SL/WL-ratio with a 2–0 single, ultra-long term, absorbent, elastic suture material can be performed in only 43% of cases (85% > 4:1 SL/WL-ratio), significantly better in midline than transverse incisions. Transverse incisions should preferably be closed in two layers to achieve a sufficient SL/WL-ratio equivalent to the median incision. Clinical Trials.gov Identifier NCT01938222.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1248-9204
DOI: 10.1007/s10029-023-02927-4
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38285168
https://repository.publisso.de/resource/frl:6516894
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....f61df704c1e66b06f64fabf29a8d73e7
Databáze: OpenAIRE
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  Data: The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations
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  Data: Aim To analyze laparotomy closure quality (suture/wound length ratio; SL/WL) and short term complications (surgical site occurrence; SSO) of conventional midline and transverse abdominal incisions in elective and emergency laparotomies with a longterm, absorbent, elastic suture material. Method Prospective, monocentric, non-randomized, controlled cohort study on short stitches with a longterm resorbable, elastic suture (poly-4-hydroxybutyrate, [p-4OHB]) aiming at a 6:1 SL/WL-ratio in midline and transverse, primary and secondary laparotomies for elective and emergency surgeries. Results We included 351 patients (♂: 208; ♀: 143) with midline (n = 194), transverse (n = 103), and a combined midline/transverse L-shaped (n = 54) incisions. There was no quality difference in short stitches between elective (n = 296) and emergency (n = 55) operations. Average SL/WL-ratio was significantly higher for midline than transverse incisions (6.62 ± 2.5 vs 4.3 ± 1.51, p p Clinically, superficial surgical site infections (SSI, CDC-A1/2) were encountered in 8%, while 4,3% were related to intraabdominal complications (CDC-A3). An abdominal wall dehiscence (AWD) occurred in 22/351 patients (6,3%)—twice as common in emergency than elective surgery (12,7 vs 5,1%)—necessitating an abdominal revision in 86,3% of cases. Conclusion We could show that a short stitch 6:1 SL/WL-ratio with a 2–0 single, ultra-long term, absorbent, elastic suture material can be performed in only 43% of cases (85% > 4:1 SL/WL-ratio), significantly better in midline than transverse incisions. Transverse incisions should preferably be closed in two layers to achieve a sufficient SL/WL-ratio equivalent to the median incision. Clinical Trials.gov Identifier NCT01938222.
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      – SubjectFull: Male
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      – SubjectFull: Laparotomy
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      – SubjectFull: Sutures
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      – TitleFull: The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations
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