title: Randomised prospective study of abdominal wall closure in patients with gynaecological cancer.
abstract: BACKGROUND
  Median laparotomy is the most common approach to the abdominopelvic cavity in patients with gynaecological tumours.
  
  
  OBJECTIVE
  The primary endpoint of the study was to evaluate the onset of incisional hernia. The secondary endpoint was to evaluate the onset of infection, wound dehiscence, wound infection, and scar pain during the post-operative period.
  
  
  METHODS
  A total of 191 patients were eligible for the study. They were divided into three groups. Group A underwent en bloc closure of the peritoneum and fascia with Premilene suture, Group B en bloc closure of the peritoneum and fascia with Polydioxanone suture, and Group C separate closure of the peritoneum and fascia with single stitches of Ethibond suture. Statistical analysis was performed using the Statistical Software Package for Social Sciences 12.0.
  
  
  RESULTS
  Group A and Group B comprised 63 patients, and Group C included 65 patients. The three groups proved homogeneous on statistical analysis (P > 0.05). The statistical analysis did not reveal significant differences between the different suture types and techniques with respect to the incidence of incisional hernia (P > 0.05).
  
  
  CONCLUSIONS
  In our study, the incidence of incisional hernia was 8%. Randomised patients were homogeneous for sample size and risk factors. No significant differences were found between suture types or techniques. Currently, there is no suture material or technique that can be considered superior to others. When possible, we believe that the best way to prevent incisional hernia is to preserve the integrity of the abdominal wall using minimally invasive techniques.
authors: Department of Obstetrics and Gynecology, University of Parma, Italy. roberto.berrettamd@gmail.com
authors: Roberto
authors: R
authors: Berretta
authors: Martino
authors: M
authors: Rolla
authors: Tito Silvio
authors: TS
authors: Patrelli
authors: Giovanni
authors: G
authors: Piantelli
authors: Carla
authors: C
authors: Merisio
authors: Mauro
authors: M
authors: Melpignano
authors: Giovanni B
authors: GB
authors: Nardelli
authors: Alberto Bacchi
authors: AB
authors: Modena
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D000042:Absorption; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000071938:Fasciotomy; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006547:Hernia / Q000453:epidemiology; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D016687:Polydioxanone; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013536:Suture Techniques; D013537:Sutures; D055815:Young Adult
chemical_list: D016687:Polydioxanone; D011098:Polyglactin 910