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Abdominal wound closure using a nonabsorbable single-layer technique.

J H Shepherd, D Cavanagh, D Riggs

    Obstetrics and Gynecology
    |February 1, 1983
    PubMed
    Summary
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    A continuous 1-layer abdominal closure using polypropylene sutures is a safe and effective technique for high-risk patients, significantly reducing the risk of evisceration and other wound complications.

    Area of Science:

    • Surgical technique
    • Abdominal closure
    • Wound healing

    Background:

    • High-risk patients undergoing abdominal surgery often face increased risks of wound dehiscence and evisceration.
    • Gynecologic malignancy patients, those with obesity, and individuals with prior radiotherapy or bowel surgery represent a significant high-risk cohort.

    Purpose of the Study:

    • To evaluate the efficacy and safety of a continuous 1-layer abdominal closure technique using polypropylene sutures.
    • To assess complication rates, specifically complete evisceration, wound infections, and incisional hernias, in a high-risk patient population.

    Main Methods:

    • A prospective study involving 200 consecutive high-risk patients with lower midline abdominal incisions.
    • Utilized a continuous 1-layer closure with number 2 polypropylene sutures.

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  • Follow-up over a 2-year period to monitor for wound complications.

    • Main Results:

    • Zero (0%) cases of complete evisceration were reported.
    • A total of 17 (8.5%) wound infections occurred.
    • Ten (5%) postoperative ventral hernias were observed, with only two requiring surgical repair.

    Conclusions:

    • Continuous 1-layer abdominal closure with polypropylene is a simple, time-saving, and successful method.
    • This technique demonstrates a low complication rate, making it suitable for high-risk patients prone to evisceration.