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Related Experiment Videos

Incisional hernia after laparotomy: prospective randomized comparison between early-absorbable and late-absorbable

W C Hsiao1, K C Young, S T Wang

  • 1Department of Surgery, National Cheng Kung University Hospital, 138 Shing-Li Road, 70428 Tainan, Taiwan, Republic of China.

World Journal of Surgery
|April 25, 2000
PubMed
Summary
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Late-absorbable polydioxanone loop suture may help prevent incisional hernias after abdominal surgery, especially in patients with malignant diseases. This finding emerged from a randomized comparison with early-absorbable polyglactin 910 suture.

Area of Science:

  • Surgical Innovation
  • Abdominal Surgery
  • Hernia Repair

Background:

  • Incisional hernia is a significant complication following laparotomy.
  • Suture material choice impacts postoperative morbidity.
  • Optimizing fascial closure is crucial for patient outcomes.

Purpose of the Study:

  • To prospectively compare early-absorbable polyglactin 910 with late-absorbable polydioxanone loop suture for fascial closure.
  • To evaluate the incidence of incisional hernias and wound infections.
  • To determine the impact of suture material on hernia development in patients with and without malignant diseases.

Main Methods:

  • Prospective, randomized trial involving 340 patients undergoing elective laparotomy.
  • Fascial closure randomized to polyglactin 910 or polydioxanone loop suture.

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  • 2-year follow-up for incisional hernias, wound infections, and mortality.

    • Main Results:

    • Overall mortality rate was 6.8%.
    • Incisional hernia incidence was 2.9% (10/340), with 7 in the polyglactin 910 group and 3 in the polydioxanone loop group.
    • Polyglactin 910 was associated with more incisional hernias, particularly in the malignant disease subgroup (4.7% vs. 0%, p=0.07).

    Conclusions:

    • Late-absorbable polydioxanone loop suture may be beneficial for preventing incisional hernias in patients with malignant diseases.
    • Suture material selection is important for reducing incisional hernia rates.
    • Postoperative wound infection was not found to be a cause of incisional hernia in this study.