The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure
Introduction: The risk of developing an incisional hernia after primary elective median laparotomy is reported in the literature as being between 5 and 20 percent. The basic of an optimal outcome after midline incision is the appropriate closure technique with or without a prophylactic mesh. The obj...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Journal of Abdominal Wall Surgery |
| Subjects: | |
| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/jaws.2022.10962/full |
| _version_ | 1811160400297721856 |
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| author | René H. Fortelny René H. Fortelny |
| author_facet | René H. Fortelny René H. Fortelny |
| author_sort | René H. Fortelny |
| collection | DOAJ |
| description | Introduction: The risk of developing an incisional hernia after primary elective median laparotomy is reported in the literature as being between 5 and 20 percent. The basic of an optimal outcome after midline incision is the appropriate closure technique with or without a prophylactic mesh. The objective of this paper is to critically examine the various closure techniques and, in particular, to present a detailed comparison of the long stitch and short stitch techniques.Method: Based on the available literature, the characteristics of the different closure techniques are described in detail, advantages and disadvantages are compared, and the current status of a practicable recommendation is discussed. Special attention is paid to the criteria of the short stitch technique, such as the suture to incision length ratio, number of stitches and distances, as well as suture material.Results: For elective midline closures, the use of a continuous closure using a slowly absorbable suture material in the small-bites technique with suture to wound ratio of at least 5:1 result in significantly lower risk of complications such as bursting abdomen and less incisional hernia rates compared to the large-bites technique.Conclusion: Based on the present evidence in midline closure after elective laparotomy the small bites technique can be recommended to significantly reduce the rate of incisional hernia. |
| first_indexed | 2024-04-10T05:56:44Z |
| format | Article |
| id | doaj.art-f5d85d7479a340fcbbf6b239c69815cb |
| institution | Directory Open Access Journal |
| issn | 2813-2092 |
| language | English |
| last_indexed | 2024-04-10T05:56:44Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Journal of Abdominal Wall Surgery |
| spelling | doaj.art-f5d85d7479a340fcbbf6b239c69815cb2023-03-03T14:48:41ZengFrontiers Media S.A.Journal of Abdominal Wall Surgery2813-20922022-12-01110.3389/jaws.2022.1096210962The Best Closure Technique Without Mesh in Elective Midline Laparotomy ClosureRené H. Fortelny0René H. Fortelny1Department of General, Viszeral and Oncologic Surgery, Wilhelminenspital, Vienna, AustriaFaculty of Medicine, Sigmund Freud Private University Vienna, Vienna, AustriaIntroduction: The risk of developing an incisional hernia after primary elective median laparotomy is reported in the literature as being between 5 and 20 percent. The basic of an optimal outcome after midline incision is the appropriate closure technique with or without a prophylactic mesh. The objective of this paper is to critically examine the various closure techniques and, in particular, to present a detailed comparison of the long stitch and short stitch techniques.Method: Based on the available literature, the characteristics of the different closure techniques are described in detail, advantages and disadvantages are compared, and the current status of a practicable recommendation is discussed. Special attention is paid to the criteria of the short stitch technique, such as the suture to incision length ratio, number of stitches and distances, as well as suture material.Results: For elective midline closures, the use of a continuous closure using a slowly absorbable suture material in the small-bites technique with suture to wound ratio of at least 5:1 result in significantly lower risk of complications such as bursting abdomen and less incisional hernia rates compared to the large-bites technique.Conclusion: Based on the present evidence in midline closure after elective laparotomy the small bites technique can be recommended to significantly reduce the rate of incisional hernia.https://www.frontierspartnerships.org/articles/10.3389/jaws.2022.10962/fullelective midline closuresmall biteslarge bitesincisional hernia preventionstitch technique |
| spellingShingle | René H. Fortelny René H. Fortelny The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure Journal of Abdominal Wall Surgery elective midline closure small bites large bites incisional hernia prevention stitch technique |
| title | The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure |
| title_full | The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure |
| title_fullStr | The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure |
| title_full_unstemmed | The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure |
| title_short | The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure |
| title_sort | best closure technique without mesh in elective midline laparotomy closure |
| topic | elective midline closure small bites large bites incisional hernia prevention stitch technique |
| url | https://www.frontierspartnerships.org/articles/10.3389/jaws.2022.10962/full |
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