Temporary Abdominal Wall Closure Using a Sterile Drape Technique

Background Chemotherapy is associated with postoperative ventral incisional hernia (PVIH) after right hemicolectomy (RHC) for colon cancer, and abdominal wall closure technique may affect PVIH. We sought to identify clinical predictors of PVIH. Methods We retrospectively analyzed patients who underwent RHC for colon cancer from 2008-2018 and later developed PVIH. Time to PVIH was analyzed with Kaplan-Meier analysis, clinical predictors were identified with multivariable Cox proportional hazards modeling, and the probability of PVIH given chemotherapy and the suture technique was estimated with Bayesian analysis. Results We identified 399 patients (209 no adjuvant chemotherapy and 190 adjuvant chemotherapy), with an overall PVIH rate of 38%. The 5-year PVIH rate was 55% for adjuvant chemotherapy, compared with 38% for none (log-rank P < .05). Adjuvant chemotherapy (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.18-2.31, P < .01), age (HR .99, 95% CI .97-1.00, P < .01), body mass index (HR 1.02, 95% CI 1.00-1.04, P < .01), and neoadjuvant chemotherapy (HR 1.92, 95% CI 1.21-3.00, P < .01) were independently associated with PVIH. Postoperative ventral incisional hernia was more common overall in patients who received adjuvant chemotherapy (46% compared with 30%, P < .01). In patients who received adjuvant chemotherapy, the probability of PVIH for incision closure with #1 running looped polydioxanone was 42%, compared with 59% for incision closure with #0 single interrupted polyglactin 910. Discussion Exposure to chemotherapy increases the probability of PVIH after RHC, and non–short stitch incision closure further increases this probability, more so than age or body mass index. The suture technique deserves further study as a modifiable factor in this high-risk population.

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Abdominal wall closure in neonates after congenital diaphragmatic hernia repair

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2013.02.008 ◽

2013 ◽

Vol 48 (5) ◽

pp. 930-934 ◽

Cited By ~ 5

Author(s):

Damian Maxwell ◽

Robert Baird ◽

Pramod Puligandla

Keyword(s):

Hernia Repair ◽

Congenital Diaphragmatic Hernia ◽

Abdominal Wall ◽

Diaphragmatic Hernia ◽

Abdominal Wall Closure ◽

Diaphragmatic Hernia Repair

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Cerebrospinal fluid shunt insertion: techniques of peritoneal catheter placement separate from abdominal fascial and peritoneal incisions

Journal of Neurosurgery ◽

10.3171/2009.9.jns09277 ◽

2010 ◽

Vol 113 (1) ◽

pp. 79-81 ◽

Cited By ~ 2

Author(s):

Abdurrahim A. Elashaal ◽

Michael Corrin ◽

Michael D. Cusimano

Keyword(s):

Abdominal Wall ◽

Csf Shunt ◽

Abdominal Wall Closure ◽

Peritoneal Catheter ◽

Effective Technique ◽

Shunt Insertion ◽

Risk Patients ◽

Abdominal Operations ◽

Insertion Techniques ◽

Almost All

Good abdominal wall closure is one of the basic surgical skills and is a common feature of almost all modernday CSF shunt operations. The fact that some patients require multiple abdominal operations highlights the need for a simple and effective technique for peritoneal catheter insertion through the abdominal wall and abdominal wall closure. Although technically simple, abdominal wall closure becomes more complex when combined with the requirement to maintain CSF shunt function in cases in which the shunt catheter passes through the abdominal wall into the peritoneal cavity. In this report, the authors describe a simple technique for passing the peritoneal catheter of a ventriculoperitoneal shunt through the abdominal wall on a pathway separate from the fascial opening. This technique minimizes the risk of abdominal wall–related complications and is especially important in high-risk patients such as those with obesity and/or diabetes and in children.

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An evaluation of abdominal wall closure in general surgical and gynecological residents

Hernia ◽

10.1007/s10029-017-1682-z ◽

2017 ◽

Vol 21 (6) ◽

pp. 873-877 ◽

Cited By ~ 4

Author(s):

Z. Williams ◽

S. Williams ◽

H. A. Easley ◽

H. M. Seita ◽

W. W. Hope

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Closure

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A Preliminary Survey on the Knowledge and Technique of Midline Abdominal Wall Closure among General Surgeons

Acta Medica Philippina ◽

10.47895/amp.v48i1.1189 ◽

2014 ◽

Vol 48 (1) ◽

Author(s):

Jose Macario V. Faylona

Keyword(s):

Abdominal Wall ◽

Preliminary Survey ◽

Abdominal Wall Closure ◽

General Surgeons

...

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Fundamentals of Temporary Abdominal Wall Closure

Fundamentals of General Surgery ◽

10.1007/978-3-319-75656-1_20 ◽

2018 ◽

pp. 265-273

Author(s):

Shelby Resnick ◽

Niels D. Martin

Keyword(s):

Abdominal Wall ◽

Abdominal Wall Closure

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MANAGEMENT AND OUTCOME OF ABDOMINAL WALL CLOSURE IN EMERGENCY LAPAROTOMY AT A TERTIARY CARE CENTRE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i12.2350 ◽

2021 ◽

Vol 5 (12) ◽

Author(s):

Mohit Badgurjar ◽

Poojan Thakor ◽

Pankaj Saxena ◽

Suman Parihar ◽

Giriraj Prajapati ◽

...

Keyword(s):

Abdominal Wall ◽

Tertiary Care ◽

Wound Complications ◽

Emergency Laparotomy ◽

Abdominal Wall Closure ◽

Suture Materials ◽

Tertiary Care Centre ◽

Mass Closure ◽

Continuous Methods ◽

Closure Group

Objective: Abdominal wall closure of an emergency laparotomy involves a great deal of consideration. An ideal laparotomy wound closure should be efficient. provide strength and serve as a barrier to infection. The aim of this study is to compare and evaluate the advantages of layered closure in comparison with the mass layered closure, the types of suture materials used in the closure, absorbable/nonabsorbable and its correlation with post operative complications such as wound sepsis, burst abdomen and incisional hernia. Methods: This prospective study was carried out over a period of 18 months enrolling a total of 90 patients split into two groups with group 1 undergoing mass closure using both interrupted and continuous methods and group 2 undergoing layered closure using both interrupted and continuous methods of suturing. Results: A higher rate of wound complications was noted in the layered closure group (37.7%) than the mass closure group (17%). Wound complications were also noted to be higher in closures done with prolene suture (37.7%) than PDS (20%). As far as techniques were concerned, interrupted and continuous suturing had a similar rate of complications. Of all the comorbidities, considered in the study, the highest rate of wound related complications were seen in patients with pulmonary complications (13.3%). Conclusion: Although the ideal way to close an abdomen post laparotomy has not yet been discovered, our study shows that mass closure with PDS suture to close the abdominal wall should be advocated as there is decreased early and late post operative wound complications Keywords: PDS.

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