European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms, Filip; Antoniou, Stavros A.; Bury, Kamil; Campanelli, G.; Conze, Joachim; Cuccurullo, Diego; Beaux, Andrew de; Deerenberg, Eva B.; East, B; Fortelny, R.; Gillion, J-F; Henriksen, Nadia A; Israelsson, Leif A.; Jairam, An P.; Jänes, Arthur; Jeekel, J.; López-Cano, Manuel; Miserez, Marc; Morales-Conde, Salvador; Sanders, Dawn; Simons, M. P.; Śmietański, Maciej; Venclauskas, Linas; Berrevoet, Frederik

doi:10.1007/s10029-014-1342-5

Cited by 510 publications

(476 citation statements)

References 144 publications

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“…There is no much data available about the comparison of mass closure technique to single layer closure but recently published European Hernia Society guidelines on abdominal wall closure recommends a single layer of aponeurosis. [12] Monofilament sutures nylon or prolene should be used. Loop suture eliminates all the knots except one [13].…”

Section: Introductionmentioning

confidence: 99%

Prospective Clinical Study: Mass Closure Versus Layer Closure of Abdominal Wall

Kumar¹,

Hastir²

2017

Int J Surg Med

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Background: Most common abdominal wall incisions are midline or paramedian and its closure technique should be efficient to provide strength for prevention of an incisional hernia and should be a barrier to infection. An incisional hernia is the most frequent complication as high as 39.9% after abdominal surgery. The integrity of sutured abdominal wound rests on the balance between suture holding a capacity of tissues and tissue holding capacity of sutures. Objective: The purpose of the study is to evaluate comparison between the mass closure and layered closure of midline and paramedian incisions for operative time and postoperative complications after performing single layered closure and conventional layered closure of laparotomy wounds like a seroma, wound infection, wound gaping, burst an abdomen and incisional hernia. Results: Meantime for the closure of laparotomy wound through a midline or Para median incision by single layered closure technique was 14 minutes, and by the layered closure, the technique was 23 minutes. There was a difference of 9 minutes statistically significant (p=0.001). In postoperative period patients closed by mass closure technique 8 patients (16%) had postoperative complications in the form of seroma in 2 patients (4%), infection in 3 patients (6%), wound gaping in 2 patients (4%) and incisional hernia in 1 patient (2%) and no patient had burst abdomen whereas in layered closure total 16 (32%) patients had complications as seroma in 5 patients (10%), wound infection in 4 patients (8%), gaping in 4 patients (8%) burst abdomen in 1 patient (2%) and incisional hernia in 2 patients (4%). Conclusion: Single layered closure technique is better than layered closure in term of operation time and postoperative complications like a seroma, infection, wound gaping, burst an abdomen and incisional hernia.

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Section: Introductionmentioning

confidence: 99%

Prospective Clinical Study: Mass Closure Versus Layer Closure of Abdominal Wall

Kumar¹,

Hastir²

2017

Int J Surg Med

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“…4,6 If the process of standardization has achieved satisfactory results in the elective surgery setting as demonstrated by recent international guidelines of the European hernia society with the introduction of globally accepted slowly absorbable running suture as gold standard for abdominal wall closure, shortage of solid evidence leaves the emergency setting an unexplored field. 5 Another controversial argument is represented by safer technique and material used for skin closure after contaminated/dirty abdominal surgery, present literature remains nowadays inconclusive and lacks strong evidences.…”

Section: Discussionmentioning

confidence: 99%

“…5 Trying to define the problem of abdominal wall closure after emergency surgery, Rahbari et al, designed the CONTINT study protocol (continuous versus interrupted abdominal wall closure after emergency midline laparotomy). 6 This RCT is still ongoing and results haven't been published yet.…”

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confidence: 99%

Searching for the safest abdominal closure technique after emergency laparotomy for Hinchey III and IV peritonitis

et al. 2017

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Background: The optimal strategy for abdominal wall closure has been an ongoing issue of debate and convincing evidence is still lacking. The INLINE systematic review and meta-analysis published on annals of surgery 2010 suggested that a running suture with a slowly absorbable suture material was the gold standard technique for abdominal wall closure after elective surgery, while there’s no general agreement in the emergency setting.Methods: Retrospective study regarding patients who underwent emergency surgery for a generalized peritonitis due to colonic perforation from 2002 to 2014 at San Gerardo hospital (Monza, Italy). Particularly study analyzed differences between continuous suture (Maxon loop, Covidien ©) and interrupted suture (Safil, B. Braun ©) for fascial closure and between metallic clips and second intention healing for incision management. After completion of data retrieval, 110 patients were included in the statistical analysis.Results: Incisional hernia rate was 15/101 (14.9%) and surgical site infection rate was 29/110 (26.4%). No significant statistical differences were found between incidence of incisional hernia and surgical site infection in the two groups, although there was a higher prevalence of incisional hernia in the running suture group (25% vs 11,7%). There was no difference between skin-stapler’s and second-intention’s wound closure groups in terms of surgical site infection and incisional hernia development.Conclusions: We consider reasonable to use an interrupted long time absorbable suture for fascial closure after emergency midline laparotomy for Hinchey III and IV peritonitis, at least in high-risk patients. Considering skin closure, suggestion is to perform a primary skin closure.

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“…This situation is due to the high cost of prostheses, which makes them less accessible in our context. The alternative might be the assessment of safer suture techniques like the one described by Lázaro Da Silva, which would give results comparable to those of the prosthetic treatment [7].…”

Section: %mentioning

confidence: 99%

“…The open suture repair is the less costly technique, but it seems to be the origin of a high rate of recidivism [4] [5]. The best technique uses synthetic prostheses [6] [7]. These prostheses are relatively high cost and less accessible in rural Africa.…”

Section: Introductionmentioning

confidence: 99%

Incisional Hernias: Risk Factors and Treatment in a Context of Limited Resources

Ouédraogo¹,

Kambire²,

Windsouri³

et al. 2017

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Background: The purpose of this study was to describe the etiologic factors and therapeutic modalities of incisional hernias in the department of surgery at the regional hospital of Tenkodogo, in Burkina Faso. Methods: It is a cross sectional study covering the period from 2010 to 2012. Sampling was comprehensive, including all the patients operated for incisional hernias during this period. Results: Fifty-four patients were included. Their average age was 22.3 years. There were 35 (64.8%) males and 19 (35.2%) female patients. We counted 28 large-size incisional hernias, 14 medium-size incisional hernias and 12 incisional hernias of small size. The average time from the first surgery to the diagnosis of incisional hernias was 8 months. Generalized acute peritonitis (44.4%) and acute intestinal obstructions (22.2%) were the main indications of initial surgical interventions. Vertical midline incisions have been involved in 37 cases (68.5%

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European Hernia Society guidelines on the closure of abdominal wall incisions

Abstract: Background The material and the surgical technique used to close an abdominal wall incision are important determinants of the risk of developing an incisional hernia.

Cited by 510 publications

References 144 publications

Prospective Clinical Study: Mass Closure Versus Layer Closure of Abdominal Wall

Prospective Clinical Study: Mass Closure Versus Layer Closure of Abdominal Wall

Searching for the safest abdominal closure technique after emergency laparotomy for Hinchey III and IV peritonitis

Incisional Hernias: Risk Factors and Treatment in a Context of Limited Resources

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