Randomised prospective study of abdominal wall closure in patients with gynaecological cancer.
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.
Berretta
Roberto
R
Department of Obstetrics and Gynecology, University of Parma, Italy. roberto.berrettamd@gmail.com
Rolla
Martino
M
Patrelli
Tito Silvio
TS
Piantelli
Giovanni
G
Merisio
Carla
C
Melpignano
Mauro
M
Nardelli
Giovanni B
GB
Modena
Alberto Bacchi
AB
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
D016687:Polydioxanone; D011098:Polyglactin 910