Page 108 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 5
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Table 4. Summary of Findings table for Key Question M: is there a place for retention sutures when closing a laparotomy?
Bibliographic citation
Study Number type of
Patient characteristics
Intervention
Comparison
Length of follow-up
Outcome measure
Khorgami et al. J Surg Res. 2013;180:238-43.
patients RCT 300
Patients undergoing midline laparotomy with ≥ 2 risk factors of a list of de ned risk factors for burst abdomen
extra retention sutures Nylon 1 (every 10 cm and with 5 cm bites of skin) kept for 3-4 weeks
continuous loop size 1 nylon suture
(1 cm from the edge /1 cm intervals)
median 5 months
Wound dehiscence was 4.1% (6/147) in the intervention group and 13.5% (20/148) in the control group (p = 0.007).
Agrawal Trop Gastroenterol. 2009;30:237-40.
RCT 190
Emergency midline laparotomy
reinforced tension line suture
continuous suture
Burst abdomen was 0.0% (0/90) in the intervention group and 13.0% (13/100) in the control group (p = 0.0026).
Rink et al Eur J Surg. 2000;166:932-7.
RCT 95 (92
Patients needing major abdominal surgery with infective or malignant intra- abdominal diseases.
+ at least one risk factor
extra retention sutures with sutures retention bridge for 12 days
interrupted Vicryl 1 sutures
12 days
“Retention sutures used to close abdominal wounds cause inconvenience, pain, and speci c morbidity.”
midline)
“We showed that prophylactic retention sutures could reduce wound dehiscence in midline laparotomy in high-risk patients with multiple risk factors without imposing remarkable postoperative complications. “
“Closure of midline incision by RTL reduces the incidence of burst abdomen.”