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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
Summary
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.
- 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.