STAPLED FASCIAL CLOSURE VS. CONTINUOUS HAND-SEWN SUTURE: EXPERIMENTAL STUDY OF THE ABDOMINAL WALL ON PORCINE MODEL
Francisco Tustumi1, George Felipe Bezerra Darce1, Murillo Macedo Lobo Filho1
1Universidade de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil.
Summary
This study found that both stapled and hand-sewn abdominal fascial closures offer similar resistance to pressure and tension. These findings suggest comparable effectiveness in preventing incisional hernias and fascial rupture.
Area of Science:
- Abdominal surgery
- Surgical techniques
- Wound healing
Background:
- Large abdominal incisions increase the risk of fascial closure rupture and incisional hernia.
- Optimal fascial closure requires uniform pressure to withstand intra-abdominal pressure.
Purpose of the Study:
- To compare the resistance to pressure and tension of stapled versus hand-sewn fascial closure methods in abdominal wall repair.
Main Methods:
- Human cadaveric and porcine models were used to evaluate fascial closure techniques.
- Three groups were tested: one-layer small bite suture, two-layer small bite suture, and two-layer stapled closure.
- Tension and intra-abdominal pressure were measured to assess closure integrity.
Main Results:
- No statistically significant differences in fascial rupture threshold (N) were found between one-layer sutured, two-layer sutured, and stapled closures in cadavers.
- Similarly, no significant differences in median intra-abdominal pressure (mmHg) were observed between the three closure groups in pigs.
- Both stapled and sutured methods demonstrated comparable resistance to pressure and tension.
Conclusions:
- Stapled and conventional hand-sewn suturing techniques exhibit similar resistance to pressure and tension thresholds for abdominal fascial closure.
- The choice between stapled and sutured methods may not significantly impact the mechanical integrity of the abdominal wall closure.
