Related Experiment Videos
Reclosure of disrupted abdominal incisions
M D Walters1, R A Dombroski, S A Davidson
1Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio.
Obstetrics and Gynecology
|October 1, 1990
Summary
Delayed wound reclosure using an en bloc technique significantly speeds healing for disrupted abdominal incisions in gynecologic patients. This method offers a faster recovery compared to healing by second intention.
Area of Science:
- Surgical technique and wound healing
- Obstetrics and Gynecology
Background:
- Disrupted abdominal incisions can result from infection, hematoma, or seroma post-surgery.
- Delayed reclosure is an alternative to secondary intention healing for such wounds.
Purpose of the Study:
- To prospectively evaluate the efficacy of a delayed en bloc reclosure technique for disrupted abdominal incisions.
- To compare the healing time and morbidity of en bloc reclosure versus healing by second intention.
Main Methods:
- Forty-one obstetric and gynecologic patients with disrupted abdominal incisions underwent initial wound management (drainage, debridement) for at least 4 days.
- Patients were randomized to either standardized en bloc wound reclosure (35 patients) or healing by second intention (6 patients).
- Healing outcomes, time to complete healing, and complications were assessed.
Main Results:
- En bloc reclosure was successful in 85.7% (30/35) of cases.
- The mean healing time for successful reclosure was 15.8 days, significantly shorter than the 71.8 days for healing by second intention (P = .002).
- Failure to reclose was associated with higher patient weight and subcutaneous infection or seroma.
Conclusions:
- Standardized en bloc reclosure of disrupted surgical incisions significantly decreases the time to complete wound healing compared to nonsurgical management.
- This technique offers minimal morbidity and a faster recovery for patients with opened abdominal wounds.