The advantage of transverse laparotomy closed with continuous absorbable single-layer stitch

Area of Science:

• Abdominal Surgery
• Surgical Incisions
• Patient Outcomes

Background:

• Chronic respiratory failure presents significant challenges in abdominal surgery.
• Minimizing surgical impact on respiratory function and blood gases is crucial for patient safety.
• Traditional longitudinal incisions can lead to complications such as dehiscence and hernias.

Purpose of the Study:

• To evaluate the benefits of transverse incisions compared to longitudinal incisions.
• To assess the impact of transverse incisions on respiratory function and blood gas composition.
• To analyze the incidence of postoperative complications associated with transverse incisions.

Main Methods:

• Comparison of transverse and longitudinal abdominal incisions.
• Assessment of respiratory function and blood gas parameters.
• Evaluation of postoperative complications including dehiscence, hernias, and wound healing.
• Detailed description of the running Smead Jones closure technique.

Main Results:

• Transverse incisions provide excellent bilateral surgical views with minimal negative effects on respiratory function and blood gases.
• Smaller retraction forces associated with transverse incisions lead to a lower incidence of dehiscences and hernias (0.8%).
• Transverse incisions interfere less with abdominal wall innervation, resulting in less pain and improved healing parameters.

Conclusions:

• Transverse incisions are advantageous for abdominal surgery, particularly in patients with chronic respiratory failure.
• The described closure technique using a continuous, absorbable, looped double suture is safe, simple, and reliable, with minimal complications.
• Transverse incisions offer superior outcomes compared to longitudinal incisions, including reduced pain, faster healing, and fewer incisional hernias.