[Abdominal wall closure in laparotomy].

Area of Science:

• Surgical techniques and wound healing.
• Abdominal surgery and peritoneal access.
• Biomaterials in surgical repair.

Context:

• Midline laparotomy is a frequent surgical approach for various abdominal procedures.
• High complication rates, including evisceration and incisional hernias (approx. 16%), persist despite various closure techniques.
• Emergency settings and contaminated surgeries exacerbate complication risks.

Purpose:

• To address the persistent high incidence of complications following midline laparotomy.
• To explore innovative methods for reinforcing surgical wounds.
• To reduce short- and medium-term complications associated with abdominal wall closure.

Summary:

• Despite extensive research on suture materials and techniques, midline laparotomy closure outcomes have not significantly improved.
• Complication rates, particularly incisional hernias and evisceration, remain substantial.
• The use of biomaterials to augment conventional sutures is proposed as a potential solution for selected patients.

Impact:

• Potential reduction in surgical site complications like incisional hernias and evisceration.
• Improved patient outcomes and reduced need for re-operation.
• Advancement in surgical wound reinforcement strategies.