title: Subcutaneous management of vertical incisions with 3 or more centimeters of subcutaneous fat.
abstract: OBJECTIVE
  This study was undertaken to determine the most appropriate management of the subcutaneous tissue of midline vertical incisions with 3 cm or more of subcutaneous fat.
  
  
  METHODS
  Patients undergoing surgery within the Division of Gynecologic Oncology at University of South Florida and East Tennessee State University with 3 cm or more of subcutaneous fat were randomly assigned to 1 of 3 groups: suture approximation of Camper's fascia, closed suction drainage of the subcutaneous space, or no intervention as a control group. Participants were evaluated daily during postoperative hospitalization and at 2 and 6 weeks postoperatively as an outpatient. Demographic information, perioperative data, and wound complications were recorded and then analyzed with chi2, t test, analysis of variance, and logistic regression where appropriate.
  
  
  RESULTS
  Two hundred twenty-five patients were enrolled with 222 eligible for evaluation. Wound complications were observed in 34 (15.3%) patients, and 25 of these women also had wound disruption. Overall wound complication and wound disruption rates were not significantly different between groups: suture (12.8%, 7.7%), drain (17.9%, 14.9%), control (15.6%, 11.7%); P = .70 and P = .39, respectively.
  
  
  CONCLUSIONS
  Suture approximation or drainage of the subcutaneous tissues of women with 3 cm or more subcutaneous fat measured in midline vertical incisions resulted in no significant change in the incidence of overall wound complications or superficial wound disruption.
authors.affiliation: Division of Gynecologic Oncology, University of South Florida, Tampa, FL, USA. rcardosi@watsonclinic.com
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Cardosi
authors.forename: Janet
authors.initials: J
authors.lastname: Drake
authors.forename: Sherri
authors.initials: S
authors.lastname: Holmes
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Tebes
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Hoffman
authors.forename: James V
authors.initials: JV
authors.lastname: Fiorica
authors.forename: William S
authors.initials: WS
authors.lastname: Roberts
authors.forename: Edward C
authors.initials: EC
authors.lastname: Grendys
mesh_terms: D019072:Antibiotic Prophylaxis; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy; D007902:Length of Stay; D008197:Lymph Node Excision; D009765:Obesity / Q000453:epidemiology; D010052:Ovariectomy; D011446:Prospective Studies; D012307:Risk Factors; D050507:Subcutaneous Fat, Abdominal / Q000601:surgery*; D013396:Suction; D013530:Surgical Wound Infection / Q000453:epidemiology; D013536:Suture Techniques