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Continuous Closure of Laparotomy Incisions: Aspects on Suture Technique

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Abstract

Wound complications such as early wound dehiscence, incisional hernia and wound infection continue to be a major source of morbidity and mortality after laparotomies.

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References

  1. Archie JP, Feldtman RW. Primary abdominal wound closure with permanent, continuous running monofilament sutures. Surg Gynecol Obstet 1981;153:721–722.

    PubMed  Google Scholar 

  2. Askew AR. A comparison of upper abdominal wound closure with monofilament nylon and polyglycolic acid. Aust NZ J Surg 1983;53:353–356.

    Article  CAS  Google Scholar 

  3. Ausobsky JR, Evans M, Pollock AV. Does mass closure of midline laparotomies stand the test of time? A random control clinical trial. Ann R Coll Surg Engl 1985;67:159–161.

    PubMed  CAS  Google Scholar 

  4. Baggish MS, Lee FWK. Abdominal wound disruption. Obstetrics & Gynecology 1975;46:530–534.

    CAS  Google Scholar 

  5. Binnie NR, Bainbridge CL, Macintyre MC. Abdominal wound closure with polydioxanone (PDS). JR Coll Surg Edinburgh 1986;31:147–150.

    CAS  Google Scholar 

  6. Blomstedt B, Welin-Berger T. Incisional hernias. A comparison between midline, oblique and transrectal incisions. Acta Chir Scand 1972;138:275–278.

    PubMed  CAS  Google Scholar 

  7. Bourne RB, Bitar H, Andreae PR, et al. In−vivo comparison of four absorbable sutures: Vicryl, Dexon Plus, Maxon and PDS. Can J Surg 1988;31:43–45.

    PubMed  CAS  Google Scholar 

  8. Bremmelgaard A, Raahave D, Beier-Holgersen R, Pedersen JV, Andersen S, Sørensen AI. Computer-aided surveillance of surgical infections and identification of risk factors. J Hosp Infect 1989;13:1–18.

    Article  PubMed  CAS  Google Scholar 

  9. Brown JP. Knotting technique and suture materials. Br J Surg 1992;79:399–400.

    Article  PubMed  CAS  Google Scholar 

  10. Brote L, Gillquist J, Tarnvik A. Wound infections in general surgery. Acta Chir Scand 1976; 142:99–106.

    PubMed  CAS  Google Scholar 

  11. Bucknall TE. Factors influencing wound complications: a clinical and experimental study. Ann R C Surg Eng 1983;65:71–77.

    CAS  Google Scholar 

  12. Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. BMJ 1982;284:931–933.

    Article  PubMed  CAS  Google Scholar 

  13. Bucknall T, Ellis H. Abdominal wound closure— A comparison of monofilament nylon and polyglycolic acid. Surgery 1981;89:672–677.

    PubMed  CAS  Google Scholar 

  14. Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdominal incisions. Eur Surg Res 1983;15:59–66.

    Article  PubMed  CAS  Google Scholar 

  15. Burleson RL. Double loop mass closure technique for abdominal incisions. Surg Gynecol Obstet 1978;147:414–416.

    PubMed  CAS  Google Scholar 

  16. Cameron AEP, Parker CJ, Field ES, et al. A randomised comparison of polydioxanone (PDS) and polypropylene (Prolene) for abdominal wound closure. Ann R Coll Surg Eng 1987;69:113–115.

    CAS  Google Scholar 

  17. Campbell JA, Temple WJ, Frank CB, Huchcroft SA. A biomechanical study of suture pullout in linea alba. Surgery 1989;106:888–892.

    PubMed  CAS  Google Scholar 

  18. Carlson MA. Acute wound failure. Surg Clin North Am 1997;77:607–636.

    Article  PubMed  CAS  Google Scholar 

  19. Carlson MA, Condon RE. Polygluconate (Maxon) versus nylon suture in midline abdominal incision closure: a prospective randomised trial. Am J Surg 1995;61:980–983.

    CAS  Google Scholar 

  20. Christou NV, Nohr CW, Meakins JL. Assessing operative site infection in surgical patients. Arch Surg 1987;122:165–169.

    PubMed  CAS  Google Scholar 

  21. Cruse PJE, Foord R. The epidemiology of wound infection: a 10−year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27–40.

    PubMed  CAS  Google Scholar 

  22. Davidson AIG, Clark C, Smith G. Postoperative wound infection: a computer analysis. Br J Surg 1971;58:333–337.

    Article  PubMed  CAS  Google Scholar 

  23. Deitel M, Alhindawi R, Yamen M, To TB, Burul CJ. Dexon plus versus Maxon fascial closure in morbid obesity: a prospective randomized comparison. Can J Surg 1990;33:302–304.

    PubMed  CAS  Google Scholar 

  24. Dudley HAF. Layered and mass closure of the abdominal wall. A theoretical and experimental analysis. Br J Surg 1970;57:664–667.

    Article  PubMed  CAS  Google Scholar 

  25. Ellis H, Bucknall TE, Cox PJ. Abdominal incisions and their closure. Current problems in Surgery 1985;22:5–50.

    Article  Google Scholar 

  26. Fagniez P-L, Hay JM, Lacàine F et al. Abdominal midline incision closure. Arch Surg 1985; 120:1351–1353.

    PubMed  CAS  Google Scholar 

  27. Gislason H, Grønbech JE, Søreide O. Burst abdomen and incisional hernia after major gastrointestinal operations — comparison of three closure techniques. Eur J Surg 1995;161:349–354.

    PubMed  CAS  Google Scholar 

  28. Greany MG. A clinical and experimental study of suture sinuses in abdominal wounds. Surg Gynecol Obstet 1982;155:712–716.

    Google Scholar 

  29. Gys T, Hubens A. A prospective clinical study between monofilament absorbable and non−absorbable sutures for abdominal wall closure. Acta Chir Belg 1989;89:265–270.

    PubMed  CAS  Google Scholar 

  30. Haley RW, Culver DH, Morgan MW, White JW, Emori TG, Hooton TM. Identifying patients at high risk of surgical wound infection. Am J Epidemiol 1985;121:206–215.

    PubMed  CAS  Google Scholar 

  31. Haxton H. The influence of suture materials and methods on the healing of abdominal wounds. Br J Surg 1965;52:372.

    Article  PubMed  CAS  Google Scholar 

  32. Holmlund DE. Knot properties of surgical suture materials. Acta Chir Scand 1974;140:355–362.

    PubMed  CAS  Google Scholar 

  33. Irvin TT, Koffman CG, Duthie HL. Layer closure of laparotomy wounds with absorbable and non−absorbable suture materials. Br J Surg 1976;63:793–796.

    Article  PubMed  CAS  Google Scholar 

  34. Irvin TT, Stoddard CJ, Greaney MG, Duthie HL. Abdominal wound healing: a prospective clinical study. Br Med J 1977:351–352.

    Google Scholar 

  35. Israelsson LA, Jonsson T. Suture length to wound length ratio and healing of midline laparotomy incisions. Br J Surg 1993;80:1284–1286.

    Article  PubMed  CAS  Google Scholar 

  36. Israelsson LA, Jonsson T. Closure of midline laparotomy incisions with polydioxanone and nylon: the importance of suture technique. Br J Surg 1994;81:1606–1608.

    Article  PubMed  CAS  Google Scholar 

  37. Israelsson LA, Jonsson T. Physical properties of self locking and conventional surgical knots. Eur J Surg 1994;160:323–327.

    PubMed  CAS  Google Scholar 

  38. Israelsson LA. Wound complications in midline laparotomy incisions: the importance of suture technique. Thesis 1995; From the Department of Surgery Lund University, Malmö General Hospital.

    Google Scholar 

  39. Israelsson LA, Jonsson T. Incisional hernia after midline laparotomy; a prospective study. Eur J Surg 1996;162:125–129.

    PubMed  CAS  Google Scholar 

  40. Israelsson LA, Jonsson T, Knutsson A. Suture technique and healing in midline laparotomy incisions. Eur J Surg 1996;162:605–609.

    PubMed  CAS  Google Scholar 

  41. Israelsson LA, Jonsson T. Overweight and healing of midline incisions: the importance of suture technique. Eur J Surg 1997;163:175–180.

    PubMed  CAS  Google Scholar 

  42. Jenkins TP. The burst abdominal wound: a mechanical approach. Br J Surg 1976;63:873–876.

    Article  PubMed  CAS  Google Scholar 

  43. Jepsen OB, Olesen Larsen S, Frølund Thomsen V. Post-operative wound sepsis in general surgery. Acta Chir Scand 1969;396 Suppl:80–90.

    CAS  Google Scholar 

  44. Johnson CD, Bernhardt LW, Bentley PG. Incisional hernia after mass closure of abdominal incisions with Dexon and Prolene. Br J Surg 1982;69:55.

    Article  PubMed  CAS  Google Scholar 

  45. Jones PL, Millman A. Wound healing and the aged patient. Nursing Clinics of North America 1990;25:263–277.

    PubMed  CAS  Google Scholar 

  46. Knight CD, Griffen FD. Abdominal wound closure with a continuous monofilament polypropylene suture. Arch Surg 1983;118:1305–1308.

    PubMed  CAS  Google Scholar 

  47. Knoop M, Lünstedt B, Thiede A. Maxon und PDS — Bewertung physikalischer und biologischer Eigenschaften monfiler, absorbierbarer Nahtmaterialien. Langenbecks Arch Surg 1987;371:13–28.

    CAS  Google Scholar 

  48. Krukowski ZH, Cusick EL, Engeset J et al. Polydioxanone or polypropylene for closure of midline abdominal incisions: a prospective comparative clinical trial. Br J Surg 1987;74:828–830.

    Article  PubMed  CAS  Google Scholar 

  49. Lamont PM, Ellis H. Incisional hernia in re−opened abdominal incisions: an overlooked risk factor. Br J Surg 1988;75:374–376.

    Article  PubMed  CAS  Google Scholar 

  50. Leaper DJ, Pollock AV, Evans M. Abdominal wound closure: a trial of nylon, polyglycolic acid and steel sutures. Br J Surg 1977;64:603–606.

    Article  PubMed  CAS  Google Scholar 

  51. Leaper DJ: Angiography as an index of healing in experimental laparotomy wounds and colonic anastomosis. Ann R Coll Surg Eng 1983;65:20–23.

    CAS  Google Scholar 

  52. Leese T, Ellis H. Abdominal wound closure— A comparison of monofilament nylon and polydioxanone. Surgery 1984;95:125–126.

    PubMed  CAS  Google Scholar 

  53. Lünstedt B, Thiede A. Polydioxanone (PDS)- ein neues monofiles synthetisches, absorbierbares Nahtmaterial. Chirurg 1983;54:103–107.

    Google Scholar 

  54. Mayer AD, Ausobsky JR, Evans M et al. Compression suture of the abdominal wall: a controlled trial in 302 major laparotomies. Br J Surg 1981;68:632–634.

    Article  PubMed  CAS  Google Scholar 

  55. McGeehan D, Hunt D, Chaudhuri A, Rutter P. An experimental study of the relationship between synergistic wound sepsis and suture materials. Br J Surg 1908;67:636–638.

    Article  Google Scholar 

  56. McNeill PM, Sugerman HJ. Continuous absorbable vs. interrupted nonabsorbable fascial closure. Arch Surg 1986;121:821–823.

    Google Scholar 

  57. Niggebrugge AHP, Hansen BE, Trimbos JB, van de Velde CJH, Zwaveling A. Mechanical factors influencing the incidence of burst abdomen. Eur J Surg 1995;161:655–661.

    PubMed  CAS  Google Scholar 

  58. Nilsson T. Closure of the abdominal wound with single−layer and double layer technique. Acta Chir Scand 1981;147:399–403.

    PubMed  CAS  Google Scholar 

  59. Osther PJ, Gjøde P, Mortensen BB, Mortensen PB, Bartholin J, Gottrup F. Randomised comparison of polyglycolic acid and polygluconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing. Br J Surg 1995;82:1080–1082.

    Article  PubMed  CAS  Google Scholar 

  60. Peacock EE, van Winkle W. Wound healing, 3rd ed. Philadelphia: W.B. Saunders; 1984.

    Google Scholar 

  61. Pollock AV, Evans M. Early prediction of late incisional hernias. Br J Surg 1989;76:953–954.

    Article  PubMed  CAS  Google Scholar 

  62. Pollock AV, Greenall MJ, Evans M. Single−layer mass closure of major laparotomies by continuous suturing. JR Soc Med 1979;72:889–893.

    CAS  Google Scholar 

  63. Poole GV. Mechanical factors in abdominal wound closure: The prevention of fascial dehiscence. Surgery 1985;97:631–639.

    PubMed  Google Scholar 

  64. Raahave D. Wound contamination and postoperative infection. Danish Medical Bulletin 1991;38:481–485.

    PubMed  CAS  Google Scholar 

  65. Richards PC, Balch CM, Aldrete J.S. A randomized prospective study of 571 patients comparing continuous vs. interrupted techniques. Ann Surg 1983;197:238–243.

    Article  PubMed  CAS  Google Scholar 

  66. vanRijssel EJC, Trimbos JB, Booster MH. Mechanical performance of square knots and sliding knots in surgery: a comparative study. Am J Obstet Gynecol 1990;162:93–97.

    CAS  Google Scholar 

  67. Roedeheaver GT, Powell TA, Thacker JG et al. Mechanical performance of monofilament synthetic absorbable sutures. Am J Surg 1987;154:544–547.

    Article  Google Scholar 

  68. Rosin E, Robinson GM. Knot security of suture materials. Vet Surg 1989;18:269–273.

    Article  PubMed  CAS  Google Scholar 

  69. Sahlin S, Ahlberg L, Granström L, Ljungström K-G. Monofilament versus multifilament absorbable sutures for abdominal closure. Br J Surg 1993; 80:322–324.

    Article  PubMed  CAS  Google Scholar 

  70. Sanders RJ, DiClementi D, Ireland K. Principles of abdominal wound closure. I. Animal studies. Arch Surg 1977;112:1184–1187.

    CAS  Google Scholar 

  71. Schoetz DJ, Coller JA, Veidenheimer MC. Closure of abdominal wounds with polydioxanone. Arch Surg 1988;123:72–74.

    PubMed  Google Scholar 

  72. Stone HH, Hoefling SJ, Strom PR et al. Abdominal incisions: Transverse vs. vertical placement and continuous vs. interrupted closure. S Med J 1983;76:1106–1112.

    Article  CAS  Google Scholar 

  73. Taylor TV. The use of polydioxanone suture in midline incisions. JR Coll Surg Edinburgh 1985;30:191–192.

    CAS  Google Scholar 

  74. Tera H, Åberg C. Tensile strengths of twelve types of knot employed in surgery, using different suture materials. Acta Chir Scand 1976;142:1–7.

    PubMed  CAS  Google Scholar 

  75. Tera H, Åberg C. Strength of knots in surgery in relation to type of knot, type of suture material and dimensions of suture thread. Acta Chir Scand 1977;143:75–83.

    PubMed  CAS  Google Scholar 

  76. Trimbos JB, Smit IB, Holm JP, Hermans J. A randomized clinical trial comparing two methods of fascia closure following midline laparotomy. Arch Surg 1992;127:1232–1234.

    PubMed  CAS  Google Scholar 

  77. Trimbos JB, vanRijssel EJ, Klopper PJ. Performance of sliding knots in monofilament and multifilament suture material. Obstet Gynecol 1986;68:425–430.

    PubMed  CAS  Google Scholar 

  78. Trimbos JB, Brohim R, vanRijssel EJC. Factors relating to the volume of surgical knots. Int J Gynecol Obstet 1989;30:355–359.

    Article  CAS  Google Scholar 

  79. Trimbos JB , vanRooij J. Amount of suture material needed for continuous or interrupted wound closure: an experimental study. Eur J Surg 1993;159:141–143.

    PubMed  CAS  Google Scholar 

  80. White H, Cook J, Ward M. Abdominal wound dehiscence. A 10-ear survey from a district general hospital. Ann R Coll Surg Eng 1977;59:337–341.

    CAS  Google Scholar 

  81. Wissing J, vanVroonhoven ThJ, Schattenkerk ME et al. Fascia closure after midline laparotomy: results of a randomized trial. Br J Surg 1987;74:738–741.

    CAS  Google Scholar 

  82. Zimmer CA, Thacker JG, Powell DM, et al. Influence of knot configuration and tying technique on the mechanical performance of sutures. J Emerg Med 1991;9:107–113.

    Article  PubMed  CAS  Google Scholar 

  83. Österberg B . Influence of physical properties of suture materials on wound infection: an experimental study. Thesis 1983; From the Department of Clinical Bacteriology of the Karolinska Institute at the Roslagstull Hospital, Stockholm.

    Google Scholar 

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© 1999 Springer-Verlag Berlin Heidelberg

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Israelsson, L.A. (1999). Continuous Closure of Laparotomy Incisions: Aspects on Suture Technique. In: Schumpelick, V., Kingsnorth, A.N. (eds) Incisional Hernia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60123-1_21

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  • DOI: https://doi.org/10.1007/978-3-642-60123-1_21

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