scholarly journals Outcome of Abdominal Wound Closure Following Continuous and Interrupted Suture in Elective Laparotomy

2014 ◽  
Vol 8 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Md Mazedur Rahman ◽  
Abdus Samad Azad ◽  
Muhammad Golam Mawla ◽  
Meer Mahbubul Alam ◽  
Md Mushfiqur Rahman
Keyword(s):  
Wound Infection ◽  
Wound Closure ◽  
Abdominal Wound ◽  
Continuous Suture ◽  
Interrupted Suture ◽  
Wound Pain ◽  
Suture Group ◽  
Group Ii ◽  
The Difference ◽  
Clean Contaminated

Closure is a crucial factor in laparotomy wound. Fascial layers provide the major tensile strength in wound closure. Poor wound healing and development of wound infection in incisional wounds are the common complications of open abdominal surgery. Continuous fascial closure commonly practiced and the interrupted closures are also practiced by some surgeon with an assumption that it causes less pain and less wound infection. The aim of this study was to determine the rate of postoperative wound infection and severity of wound pain following interrupted and continuous abdominal wound closure. A comparative cross-sectional study was done at the Department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total 100 patients of clean-contaminated elective laparotomy were selected. The patients were randomly divided into two groups. Every odds number was included in group-I (interrupted suture) and every even number was included in group-II (continuous suture). Total 14% wound infection was detected in interrupted suture group where as wound infection was 18% in continuous suture group of wound closure. Though the wound infection is higher in group-II but the difference of wound infection is not statistically significant between two groups. The wound pain assessed in seven postoperative days was higher in continuous closure group than interrupted group but the difference was not significant. There is no significant difference of wound infection and wound pain between interrupted and continuous suture group in clean-contaminated laparotomy. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20373 Faridpur Med. Coll. J. 2013;8(2): 73-76

scholarly journals Abdominal midline wound closure with small bites versus large bites: a randomized comparative trial

2020 ◽  
Vol 7 (5) ◽  
pp. 1391
Author(s):  
Rajat Sharma ◽  
Amitpal Kaur ◽  
Mohit Sharma ◽  
Karaninder Singh ◽  
Neeti Rajan Singh
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Wound Closure ◽  
Elective Surgery ◽  
Comparative Trial ◽  
Suture Technique ◽  
Abdominal Wound ◽  
Midline Laparotomy ◽  
Significant Difference ◽  
Group A

Background: The optimal strategy of abdominal wall closure after midline laparotomy has remained an issue of ongoing debate to minimize incidence of incisional hernia which occurs in 10 to 23% cases postoperatively. The main objective of the study was to evaluate the efficacy of small bites versus large bites suture technique in reduction of incidence of the complications like pain, wound infection, wound dehiscence, seroma formation and incisional hernia by using polydioxanone no.1.Methods: The present study was conducted on 100 patients undergoing elective surgery who were randomly allocated into group A and B. Group A were the patients in which midline abdominal wound closure was done with small bites and group B were the patients in which midline abdominal wound closure was done with large bites. Then the patients were followed up for 6 months to observe any complications.Results: A mean additional closure time of 9 minutes was seen with the small bites technique. The mean suture length was more in small bites group as compared to large bites technique. There was no difference in the visual analog scale score between the two groups. No significant difference was seen in the incidence of major and minor wound infection postoperatively in both the groups. Small bites technique reduced the incidence of suture sinus and incisional hernia compared to conventional large bites technique.Conclusions: It can be concluded that the small bites suture technique is more effective than the traditional large bites technique for prevention of all post-operative complications.

Comparison of Wound Infection in Uncomplicated Acute Appendicitis by Subcuticular Suture and Interrupted Suture

2021 ◽  
Vol 21 ◽  
Author(s):  
Farshad Zarei ◽  
Mojtaba Ahmadinejad
Keyword(s):  
Acute Appendicitis ◽  
Wound Infection ◽  
Interrupted Suture ◽  
Operative Outcomes ◽  
Significant Difference ◽  
Patient Reported ◽  
Cosmetic Outcomes ◽  
The Difference ◽  
Uncomplicated Acute Appendicitis ◽  
Suturing Techniques

Background: Postoperative complications such as; wound infection and scaring are some of the major concerns regarding suturing techniques. This study is designed to evaluate post-operative outcomes of adhering subcuticular sutures in comparison to interrupted suturing method in patients who underwent appendectomy for uncomplicated acute appendicitis. Methods: 240 patients were randomly assigned into two groups; 120 with interrupted and 120 subcuticular sutures after appendectomy, at Shohada Ashayer hospital, Khorramabad, Iran. The prevalence of wound infection, three days after the surgery in the hospital and a week after discharged was determined and evaluated statistically. Results: No wound infection was seen within three days of hospitalization in subcuticular group whereas, 1 patient reported infection in interrupted group, however the difference was not statistically significant. A week after discharge, a patient was reported to have wound infection in subcuticular group and 2 in interrupted group. No significant difference was seen in this regard either. 55 females and 66 males received subcuticular sutures whereas, 74 males and 46 females were given interrupted sutures for wound closing. One male in interrupted and 1 male and female subcuticular group was referred for wound infection, after discharge, respecitvely. Among these groups, no significant differences were seen. In catarrhal appendicitis, infection was reported in interrupted group only which was not statistically significant. Conclusions: Subcuticular sutures provide better cosmetic outcomes without any additional complications in comparison to interrupted sutures.

scholarly journals Skin stapler versus sutures in abdominal wound closure

2017 ◽  
Vol 4 (9) ◽  
pp. 3062
Author(s):  
Fobin Varghese ◽  
Jose Gamalial ◽  
John S. Kurien
Keyword(s):  
Wound Infection ◽  
Wound Closure ◽  
Visual Analogue Score ◽  
P Value ◽  
Skin Closure ◽  
Chi Square ◽  
Skin Staples ◽  
Suture Group ◽  
Study Population

Background: Wound closure is as important as any other action performed by the surgeon. Apart from the need for producing a healthy and strong scar, it is the surgeon’s responsibility to ensure its aesthetically pleasing physical appearance. Skin staples are an alternative to regular sutures in offering this advantage. The present study has helped to highlight the benefits of skin stapler.Methods: Out of the 120 participants, 60 underwent skin closure with Stainless steel skin staples and the remaining 60 with non-absorbable Polyamide mattress sutures randomly. They all received one mandatory dose of pre-operative parenteral antibiotic 1 hour prior to the incision. On the 3rd postoperative day, the wound was evaluated for inflammation, infection and wound gape. Participants were re-evaluated for infection/gape/inflammation during follow-up on 7th day. The wounds were evaluated at 1 months follow up which were rated for cosmesis by Visual Analogue Score. The data was coded and entered in Microsoft excel and then analysed using statistical software SSPS.Results: Study population consisted of 79 males (65.8%) and 41 females (34.2%). Mean age of the study population was 49.35 with an SD 16.739. Wound infection was found to be higher in stapler group (30%) when compared to conventional suture group (11.7%)which was found to be statistically significant with chi-square value 6.114 and p value 0.013. Mean time for closure was significantly shorter in stapler group 4.55 minutes, when compared to suture group (11.22 minutes). Better cosmetic outcome was observed in conventional suture group.Conclusions: Preventing wound infection, especially in abdominal wounds, is of importance as it may lead to wound gaping. Incidence of post-operative wound infection was more with skin staples. Cosmesis is essential and important aspect in this day and age. A cosmetic scar not only gives satisfaction to the patient but also mental ease to the surgeon. Conventional sutures provided better cosmetic result when compared with skin staplers.

scholarly journals A comparative study of skin staples and conventional sutures for abdominal skin wound closures

2019 ◽  
Vol 6 (6) ◽  
pp. 2168
Author(s):  
Sagar S. Kathare ◽  
Nandkishor D. Shinde
Keyword(s):  
Wound Closure ◽  
Elective Surgery ◽  
Skin Wound ◽  
P Value ◽  
Cosmetic Results ◽  
Skin Staples ◽  
Surgical Wounds ◽  
Wound Pain ◽  
Suture Group ◽  
Patients Acceptance

Background: The objectives of the study were to study the operative time, the effect on wound healing, cosmetic results, patients acceptance and total cost with the use of sutures and staples.Methods: The study was conducted on 100 patients who were undergoing elective surgery from January 2016 to July 2017 in our institute. The patients were randomly selected to receive either suture or staple.Results: The study group included 50 patients who underwent wound closure by staplers and 50 patients underwent suturing. The commonest region of the surgical wounds was Mc Burneys site. The time taken for wound closure using staplers showed statistically significance difference over closure with suture, it took the stapler 4 times less duration to perform wound closure. The average cost of using stapler was higher than suturing. The appearance of the scar among the staple group was good in 90% of those who returned for follow-up at 1 month, 10% had average scar. The patients acceptance was better in staple group with less pain during removal as compared to suture group. P-value calculated using students unpaired T-test. P<0.0001 which was highly significant.Conclusions: Staples did not cause excess wound pain and allows saving in time with better cosmetic results.

scholarly journals Experience of small tissue bites with conventional tissue bites in emergency setting for midline abdominal wound closure

2022 ◽  
Author(s):  
Varun Dogra ◽  
Silvi Sandhu ◽  
Ishfaq Ahmad Gilkar ◽  
Shyam Gupta
Keyword(s):  
Wound Closure ◽  
Abdominal Cavity ◽  
Emergency Setting ◽  
Abdominal Wound ◽  
Site Infection ◽  
Midline Incision ◽  
Midline Laparotomy ◽  
Small Tissue ◽  
Group I ◽  
Group Ii

Background: Midline incision provides excellent access to the abdominal cavity. However, wound infection following a laparotomy can increase morbidity as well as burden on health care system. Wound prognosis can be influenced by the type of incisions, suture material and the method of closure. This study aimed to assess the outcome of midline abdominal wound closure using two different techniques of wound closure.Methods: This was a prospective observational study and consisted of 300 consecutive patients ≥18 years of age undergoing abdominal surgery through a midline incision in emergency setting. Patients who were included in the study were then randomised into two groups. In group I, midline laparotomy was closed with large tissue bites and in group II small tissue bites were used.Results: Out of 300 patients included in this study, 150 patients were subjected to large tissue bites and another 150 patients to small tissue bites. 29 patients out of 150 patients (19%) in large tissue bites group and 16 patients (11%) in small tissue bites developed surgical site infection (SSI). 23 patients out of 50 patients (15%) in large tissue bites group and 11 patients (7%) in small tissue bites developed wound dehiscence.Conclusions: In this study, we found that the patients in group II whose midline laprotomy was closed with small tissue bites had better wound outcome postoperatively in terms of wound site infection and wound dehiscence.

scholarly journals Needle Adjustment Free (NAF) running suture technique (PAN suture) in laparoscopic partial nephrectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun-wei Pan ◽  
Xiang Zhang ◽  
Xing-wei Jin ◽  
Xiao Liu ◽  
Wei-chao Tu ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Conversion Rate ◽  
Suture Technique ◽  
Laparoscopic Partial Nephrectomy ◽  
Continuous Suture ◽  
Discharge Time ◽  
Open Conversion ◽  
Traditional Technique ◽  
Affected Side ◽  
Suture Group

Abstract Background It is proposed a new running suture technique called Needle Adjustment Free (NAF) technique, or PAN suture. The efficiency and the safety were evaluated in laparoscopic partial nephrectomy. Methods This new running suture technique avoids the Needle Adjustment method used in traditional techniques. The new continuous suture technique (11 patients) was compared with the traditional continuous suture method (33 patients) used in both transperitoneal and retroperitoneal laparoscopic partial nephrectomy (LPN) in terms of suture time (ST), warm ischemia time (WIT), blood loss (BL), open conversion rate and post-op discharge time, post-op bleeding, post-op DVT, ΔGFR (affected side, 3 months post-op). Differences were considered significant when P < 0.05. Results ST in the PAN suture group was 30.37 ± 16.39 min, which was significant shorter (P = 0.0011) than in the traditional technique group which was 13.68 ± 3.33 min. WIT in the traditional technique group was 28.73 ± 7.89 min, while in the PAN suture group was 20.64 ± 5.04 min, P = 0.0028. The BL in entirety in the traditional technique group was 141.56 ± 155.23 mL, and in the PAN suture group was 43.18 ± 31.17 mL (P = 0.0017). BL in patients without massive bleeding in the traditional technique group was significantly greater than in the PAN suture group at 101.03 ± 68.73 mL versus 43.18 ± 31.17 mL (P = 0.0008). The open conversion rate was 0 % in both groups. There was no significant difference between the two groups in postoperative discharge time, post-op bleeding, post-op DVT, ΔGFR (affected side, 3 months post-op). Conclusions The NAF running suture technique, or PAN suture, leading to less ST, WIT and BL, which was shown to be more effective and safer than the traditional technique used for LPN. A further expanded research with larger sample size is needed.

39 Managing Burn Wounds with Silvadene

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S29-S30
Author(s):  
Tomer Lagziel ◽  
Louis J Born ◽  
Luis H Quiroga ◽  
Eliana Duraes ◽  
Pragna N Shetty ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Wound Infection ◽  
Standard Of Care ◽  
Infection Rates ◽  
Average Amount ◽  
Once Daily ◽  
Preliminary Results ◽  
The Difference ◽  
Dressing Change ◽  
Hospital Acquired

Abstract Introduction Topical delivery of antibacterial agents is typically incorporated and is an essential component of burn wound therapy. The goal is to prevent infection and promote the healing process. Poorly treated wounds can result in scarring or severely in sepsis and multi-organ dysfunction. Topical SSD cream has been the gold-standard for initial local care in partial thickness or full thickness burns. Due to immediate burst release of the drug into the exposed areas, application is relatively frequent (usually twice daily). However, it remains unknown whether twice-daily SSD dressings are superior to once-daily. Methods We maintained a twice-daily dressing change standard of care until 01/01/2019. Patients admitted after that date had their dressing changed once-daily. Our goal is to review outcomes for 75 patients before the change-of-practice and 75 patients after. The main outcomes recorded are wound infection rates, hospital-acquire complications (non-wound related), pain scores, daily narcotic requirements, average amount of SSD used, and length-of-stay. Results Preliminary results of the 75 pre-change-of-practice and 75 post-change-of-practice patients showed slightly better outcomes in the post-change group. Wound-infection rates were the same for both groups (pre=5.33%, post=5.33%), average daily pain-levels for the pre-change group were slightly higher but the difference was negligible and not statistically significant (pre=5.76, post=5.69). The pre-change group had a higher average daily narcotic dosage (pre=6.81mg, post=6.38mg), hospital-acquired complication rates were higher pre-change (pre=10.67%, post=6.67%), and length-of-stay was longer in the pre-change group (pre=10.81, post=9.25). The average amount of SSD jars used per patient was higher as well (pre=6.30, post=2.85). Statistical analysis of the distribution of burn type, age, and burn depth showed no discrepancy and a generalized decreased length-of-stay with once-daily SSD dressing change. Conclusions Preliminary results show that once-daily dressing changes of SSD in burn wounds have no negative impact on wound outcomes. However, it is associated with a decreased length-of-stay, decreased pain levels, and less hospital-acquired complications. A decreased length-of-stay means reduced medical expenses for the patient and the hospital. In addition, less hospital-acquired complications result in better patient recovery. Since the difference in wound outcomes is negligible and statistically insignificant, changing the standard-of-care to once-daily could prove beneficial.

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

Seasonal variations in wool growth and heat tolerance of sheep. I. Wool growth

1960 ◽  
Vol 11 (1) ◽  
pp. 75 ◽  
Author(s):  
M Wodzicka
Keyword(s):  
Body Weight ◽  
Day Treatment ◽  
The Other ◽  
Seasonal Rhythm ◽  
Group Iii ◽  
Wool Growth ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference

The monthly wool growth of three groups of rams was studied at Beltsville, Maryland. Group I received natural daylight (at 38° 53' N.) and was shorn monthly. Group II had a 7:17 hours of daylight to hours of darkness rhythm and was shorn every 6 months, once in winter and once in summer. Group III received natural daylight and was likewise shorn every 6 months. The rams of all groups produced more wool in summer than in winter. This difference was significant (P<0.001). The mean body weight and food intake were both greater in the winter months, which indicated that the seasonal rhythm of wool growth was not a consequence of poorer feeding in winter. The rams which were shorn monthly (group I) grew considerably more wool than the other two groups, but the difference was not statistically significant. The short-day treatment of group II did not increase the annual wool production nor decrease the seasonal rhythm of wool growth. The balance of evidence from this and other experiments indicates that temperature rather than light controls the seasonal rhythm of wool growth.

Compare the Incidence of Surgical Site Infection after Appendectomy Wound Irrigation with Normal Saline and Imipenem Solutions

2021 ◽  
Vol 15 (8) ◽  
pp. 2184-2186
Author(s):  
Ahmad Shah ◽  
Nazeer Ahmad Sasoli ◽  
Farrukh Sami
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Saline Solution ◽  
Abscess Formation ◽  
Site Infection ◽  
Wound Irrigation ◽  
Group I ◽  
Perforated Appendix ◽  
The Mean ◽  
Group Ii

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

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