Closure of the abdominal fascia after clean and clean-contaminated laparotomy.
This prospective, randomized study compares continuous absorbable suture (Dexon), continuous nonabsorbable suture (Surgilon) and interrupted absorbable suture (Dexon) for fascial closure of clean and clean-contaminated laparotomy wounds. Three months postoperatively, the overall frequencies were for wound dehiscence 0% (0/238), wound infection 5.5% (13/238), hernia formation 0.4% (1/238) and sinus formation 0% (0/238). After a median period of 41 months (range 14-59 months) a physical examination was performed in 93.7% (224/238) of the patients and the observed overall frequency of hernia was 3.1% (7/224). No difference was detected in incidence of wound complications when comparing the three groups. We conclude that layered closure of a laparotomy wound is safe whether using nonabsorbable or absorbable sutures and whether applying a continuous or interrupted technique in the fascial closure of clean and clean-contaminated wounds.
Larsen
P N
PN
Department of Surgery, County Hospital of Frederiksborg, Frederikssund, Denmark.
Nielsen
K
K
Schultz
A
A
Mejdahl
S
S
Larsen
T
T
Moesgaard
F
F
D000009:Abdominal Muscles / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000071938:Fasciotomy; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013537:Sutures