Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure

Bloemen, Arthur; Dooren, P. van; Huizinga, Bernou F.; Hoofwijk, A. G. M.

doi:10.1002/bjs.7398

Cited by 84 publications

(65 citation statements)

References 40 publications

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“…7,8 In the study conducted by Israelsson et al and Bloemen et al the incidence of wound infection is 9.4% and 7.7% respectively in mass closure group. 9,10 In present study wound infection rate in layered closure group is 6.66%, As compared to studies by Ellis H et al (5%) and Kendal et al study (5%) rate of infection in present study is higher. As compared to mass closure wound infection is higher in layered closure, it may be due to more tissue handling, more exposure of wound to atmosphere air.…”

Section: Discussioncontrasting

confidence: 48%

Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

Deshmukh¹,

Maske²

2018

Int Surg J

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Background: The ideal method of abdominal wound closure remains to be discovered. It should be technically so simple that the results are as good in the hands of a trainee as in those of the master surgeon. The best abdominal closure technique should be fast, easy, and cost effective while preventing both early and late complications. Present study is undertaken to compare the two methods (Mass closure and Layered closure) of laparotomy wound closure in relation to post-operative complications, time for wound closure and cost effectiveness in both groups and also to decide the most effective method among the two.Methods: This prospective comparative study was conducted in department of surgery at a tertiary care teaching hospital at Solapur (Maharashtra) from January 2006 to January 2009. On admission, patients suspected of having intraabdominal pathology, a thorough clinical e and general assessment was done. Necessary radiological and biochemical investigations were done to support the diagnosis. After confirmation of diagnosis patients were subjected for exploratory laparotomy. The laparotomy wound was closed with either by Mass closure or Layered closure technique. Patients were followed up for 6 months in post-operative period for detection late complications.Results: Total 60 patients of were studied. Majority of patients were in 61 to 65 age group. Male outnumbered the females. Incidence of early complications like seroma, wound infection is more in layered closure group as compared to mass closure. Mean wound closure time is more in layered closure group. Mass closure technique is more cost effective than layered closure group.Conclusions: Mass closure technique is less time consuming, more cost effective and safe for closure of midline laparotomy incisions.

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Section: Discussioncontrasting

confidence: 48%

Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

Deshmukh¹,

Maske²

2018

Int Surg J

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“…The overall incidence of wound dehiscence in this study was 11.5 %. No other study has reported such a higher incidence of postoperative wound dehiscence with the use of Prolene and Vicryl except one study conducted by Brolin [18] comparing Ethibond and PDS® (P00.04) in midline fascial closure in gastric bariatric operations and another by Bloemen et al [20] comparing Prolene and PDS (polydioxanone) for midline abdominal wound closure (P00.229). Chi square equals 5.994.…”

Section: Randomized N= 211mentioning

confidence: 99%

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

Pandey

Singh

et al. 2012

Indian J Surg

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Wound dehiscence is a postoperative complication encountered following abdominal surgery. A prospective randomized study was conducted to compare the incidence of wound dehiscence with a delayed absorbable and a nonabsorbable suture material in the mass closure of vertical laparotomy wounds. In one group, 100 patients were analyzed after closure with Prolene®, and in another group, 100 patients were analyzed after closure with Vicryl®. The incision was closed by continuous far and near suture technique using polypropylene (Prolene) suture in one group and a synthetic delayed absorbable polyglactin 910 (Vicryl) suture in the other group. There was significant difference in the incidence of wound dehiscence between the two groups: 6 % with Prolene and 17 % with Vicryl, (χ 2 05.944, 1 DF, P value00.0148). The overall incidence of wound dehiscence was 11.5 % in this study. The incidence of wound dehiscence in both the study groups was higher than expected as compared to previous literature. There was a significant difference between the two suture materials. In our study, Prolene is a better suture material for closure of vertical laparotomy wounds.

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“…[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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Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure

Abstract: ISRCTN65599814 (http://www.clinical-trials.com).

Cited by 84 publications

References 40 publications

Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

A Prospective Randomized Study Comparing Non-absorbable Polypropylene (Prolene®) and Delayed Absorbable Polyglactin 910 (Vicryl®) Suture Material in Mass Closure of Vertical Laparotomy Wounds

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

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