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Absorbable Barbed Continuous versus Nonabsorbable Nonbarbed Interrupted Suturing Methods for Donor-site Closure of
Daiki Kitano1, Tadashi Nomura1, Shunsuke Sakakibara1
1Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract:
Abdominal incisional hernia is a complication of the rectus abdominis myocutaneous (RAMC) flap harvest. This study aimed to compare the incidence of abdominal incisional hernia and donor-site closure time between absorbable barbed continuous (ABC) and non-absorbable non-barbed interrupted (nAnBI) methods.
Methods:
This study included 145 patients who underwent free RAMC flap reconstruction after head and neck cancer surgery at Kobe University Hospital between January 2012 and March 2020. The nAnBI method was selected between January 2012 and August 2016, and the ABC method was selected between September 2016 and March 2020. The incidence of abdominal incisional hernia and the average time required for donor-site closure were compared between the two groups.
Results:
Of the 145 patients surveyed, 116 (57 and 59 in the nAnBI and ABC groups, respectively) were followed-up for at least 90 days after the surgery. The incidence rates of abdominal incisional hernia were 0% and 5.1% (n = 3) in the nAnBI and ABC groups, respectively, with no significant differences (p = 0.244). The average donor-site closure times were 127.6 and 111.3 minutes in the nAnBI and ABC groups, respectively, with no significant differences (p = 0.122).
Conclusions:
No significant differences in the incidence of abdominal incisional hernia and donor-site closure time were observed between the nAnBI and ABC groups. However, there was a tendency for increased hernia occurrence and shorter wound closure time in the ABC group. A randomized prospective multicenter study is warranted to validate our findings of the ABC method.
Insights
Comparing surgical closure methods for rectus abdominis myocutaneous (RAMC) flap harvest, this study found no significant difference in abdominal incisional hernia rates or closure time between absorbable barbed continuous (ABC) and non-absorbable non-barbed interrupted (nAnBI) techniques.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Hernia Repair
Background:
- Abdominal incisional hernia is a known complication following rectus abdominis myocutaneous (RAMC) flap harvest.
- Surgical techniques for donor-site closure aim to minimize complications and operative time.
- Comparing novel barbed sutures with traditional methods is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the incidence of abdominal incisional hernias after RAMC flap harvest.
- To evaluate donor-site closure time between absorbable barbed continuous (ABC) and non-absorbable non-barbed interrupted (nAnBI) closure methods.
Main Methods:
- A retrospective study of 145 patients undergoing free RAMC flap reconstruction for head and neck cancer.
- Patients were divided into two groups based on closure method: nAnBI (January 2012-August 2016) and ABC (September 2016-March 2020).
- Comparison of hernia incidence and average donor-site closure time, with follow-up of at least 90 days for 116 patients.
Main Results:
- The incidence of abdominal incisional hernia was 0% in the nAnBI group and 5.1% in the ABC group (p=0.244), showing no statistically significant difference.
- Average donor-site closure times were 127.6 minutes for nAnBI and 111.3 minutes for ABC (p=0.122), also without significant difference.
- A trend suggested increased hernia occurrence and shorter closure time with the ABC method.
Conclusions:
- Neither the nAnBI nor the ABC method demonstrated a significant difference in hernia incidence or closure time.
- The ABC method showed a trend towards faster closure and slightly higher hernia rates.
- Further validation through a randomized prospective multicenter study is recommended for the ABC method.
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