scholarly journals A STUDY ON LAYERED CLOSURE VERSUS MASS CLOSURE OF LAPAROTOMY INCISIONS

2021 ◽  
pp. 48-49
Author(s):  
Therani Dorababu ◽  
Kumaran R
Keyword(s):  
Wound Closure ◽  
Tertiary Care ◽  
Late Complications ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Mass Closure ◽  
Laparotomy Wound ◽  
Ideal Method ◽  
Closure Group ◽  
The Ideal

Background: The ideal method of abdominal wound closure remains to be discovered. It should be technically so simple that the results are as good in the hands of a trainee as in those of the master surgeon.The best abdominal closure technique should be fast, easy while preventing both early and late complications. Present study is undertaken to compare the two methods (LAYERED closure and MASS closure) of laparotomy wound closure in relation to postoperative complications,time for wound closure in both groups and also to decide the most effective method among the two. Methods: This study was conducted in department of surgery at a tertiary care teaching hospital at KANCHIPURAM (TAMILNADU) from DECEMBER 2019 to DECEMBER 2020. On admission,patients suspected of having intraabdominal pathology,a thorough clinical examination and general assessment was done.Necessary radiological and biochemical investigations were done to support the diagnosis. After confirmation of diagnosis patients were subjected for exploratory laparotomy.The laparotomy wound was closed with either by Mass closure or Layered closure technique. Patients were followed up for 6 months in post-operative period for detection of late complications. Results:Total 60 patients of were studied.Majority of patients were in 66 -75 age group.Male outnumbered the females. Incidence of early complications like seroma, wound infection is more in layered closure group as compared to mass closure.Mean wound closure time is more in layered closure group. Conclusions: Mass closure technique is less time consuming,safe for closure of midline laparotomy incisions.

scholarly journals Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

2018 ◽  
Vol 5 (2) ◽  
pp. 584 ◽  
Author(s):  
Santoshkumar N. Deshmukh ◽  
Audumbar N. Maske
Keyword(s):  
Comparative Study ◽  
Wound Closure ◽  
Tertiary Care ◽  
Cost Effective ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Mass Closure ◽  
Prospective Comparative Study ◽  
Laparotomy Wound ◽  
Closure Group

Background: The ideal method of abdominal wound closure remains to be discovered. It should be technically so simple that the results are as good in the hands of a trainee as in those of the master surgeon. The best abdominal closure technique should be fast, easy, and cost effective while preventing both early and late complications. Present study is undertaken to compare the two methods (Mass closure and Layered closure) of laparotomy wound closure in relation to post-operative complications, time for wound closure and cost effectiveness in both groups and also to decide the most effective method among the two.Methods: This prospective comparative study was conducted in department of surgery at a tertiary care teaching hospital at Solapur (Maharashtra) from January 2006 to January 2009. On admission, patients suspected of having intraabdominal pathology, a thorough clinical e and general assessment was done. Necessary radiological and biochemical investigations were done to support the diagnosis. After confirmation of diagnosis patients were subjected for exploratory laparotomy. The laparotomy wound was closed with either by Mass closure or Layered closure technique. Patients were followed up for 6 months in post-operative period for detection late complications.Results: Total 60 patients of were studied. Majority of patients were in 61 to 65 age group. Male outnumbered the females. Incidence of early complications like seroma, wound infection is more in layered closure group as compared to mass closure. Mean wound closure time is more in layered closure group. Mass closure technique is more cost effective than layered closure group.Conclusions: Mass closure technique is less time consuming, more cost effective and safe for closure of midline laparotomy incisions.

scholarly journals A clinical study of continuous and interrupted fascial closure in emergency midline laparotomy at a tertiary care centre

2017 ◽  
Vol 4 (6) ◽  
pp. 2014
Author(s):  
Rahul D. Kunju ◽  
Vinayak Thakkannavar ◽  
Shrivathsa Merta K. ◽  
Sachin H. G. ◽  
Allen Netto ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Wound Closure ◽  
Tertiary Care ◽  
Fascial Closure ◽  
Emergency Laparotomy ◽  
Closure Technique ◽  
Burst Abdomen ◽  
Midline Laparotomy ◽  
Laparotomy Wound

Background: Commonest approach in emergency open abdominal surgeries remains to be midline laparotomy because it is simple, saves time and causes minimal blood loss. Optimal technique for laparotomy wound closure has been a topic of debate since long. Risk factors for development of incisional hernia and burst abdomen are wound infection, systemic illnesses of patient and closure technique. Factors related to patients like age, gender, body mass index (BMI), systemic illnesses are not modifiable when an emergency laparotomy is the only option. Hence closure technique is one factor where surgeon has total control, which can bring down the incidence of burst abdomen and incisional hernias.Methods: Prospective study conducted in 150 patients who underwent emergency midline laparotomy from December 2014 to February 2016 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India with 6 months’ follow-up after surgery.Results: Most of patients in the study belonged to 30-40-year group and were males (78%). Gastrointestinal perforation peritonitis (52%) was the single most common indication for emergency midline laparotomy. In the continuous and interrupted groups, post-operative wound infection was found in 54.6% and 34.6%, wound dehiscence was found in 16% and 6.6% and incisional hernia in 14.4% and 4% respectively.Conclusions: Interrupted suturing is superior to continuous technique in emergency midline laparotomy wound closure in terms of complications and post-operative morbidity.

scholarly journals A comparative study of single layer closure versus conventional layered closure of laparotomy wounds

2018 ◽  
Vol 5 (4) ◽  
pp. 1459
Author(s):  
Akash Bande ◽  
Divish Saxena ◽  
Prabhat B. Nichkaode ◽  
Murtaza Akhtar
Keyword(s):  
Abdominal Wall ◽  
Tertiary Care ◽  
Single Layer ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Linea Alba ◽  
Mass Closure ◽  
Interrupted Suture ◽  
Closure Group ◽  
Better Than

Background: The goal of wound closure after laparotomy is to restore the function of the abdominal wall. The techniques for closure of anterior abdominal wall includes either layered closure, modified Smead-Jones technique, mass closure or retention suture or combination of above mentioned techniques. The studies which compared the continuous and interrupted suture techniques have concluded that enmass continuous sutures have an advantage of holding the fascia together. The present study tries to compare the two techniques i.e. single layer closure (mass closure) and layered closure in patients undergoing laparotomy by midline incision in tertiary care hospital.Methods: 97 patients undergoing either emergency or elective midline laparotomy were included in the study, where in 64 patients laparotomy closure was done in single layer using polypropylene 1-0 and in 33 patients by layered closure where peritoneum was closed with polygalactin 2-0 and linea alba by polypropylene 1-0. Patients were allocated two groups as per convenience of operating surgeon without using any method of randomization.Results: The single layer closure technique required statistically significant less closure time of 18.2±3.2 minutes as compared to conventional layered closure 26.4±4 minutes time of (p <0.001). Also, the incidence of postoperative complications was found to be comparatively less (17.18%) in single layer closure group as compared to complications (42.42%) in layered closure group.Conclusions: Single layer closure technique continues to be better than conventional layered closure technique of laparotomy wounds in terms of operative time and post-operative complications.

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

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.

scholarly journals Closure Methods for Midline Laparotomy Incisions Following Abdominal Surgery - A Comparative Study from Central India

2021 ◽  
Vol 8 (24) ◽  
pp. 2089-2093
Author(s):  
Hari Om Singh Sengar ◽  
Kailash Charokar ◽  
Prashant Nema
Keyword(s):  
Comparative Study ◽  
Wound Complications ◽  
Absorbable Suture ◽  
Midline Laparotomy ◽  
Mass Closure ◽  
Group A ◽  
Group B ◽  
Closure Method ◽  
Closure Group ◽  
Laparotomy Incision

BACKGROUND The method adopted for incision closure has an influence on the outcomes of wound healing. The study was conducted to compare the ‘mass closure’ method with the conventional layer closure, and to find out the suitable surgical closure method for midline laparotomy incision. METHODS A prospective comparative study was conducted at a tertiary care teaching institute over a period of 2 years. Patients > 14 years of age, who were operated on by midline laparotomy incision, were included in the study group (N = 60). Either a ‘mass closure’ or the conventional layer closure method was adopted as per the operating surgeon’s choice. Based on the method used the cases were allocated into two groups, each with 30 patients. In the ‘mass closure’ group (Group A), continuous suturing was used in 22 patients and interrupted closure in 8 patients. In the ‘layered closure’ group (Group B), the abdomen was closed in layers using absorbable suture for the peritoneum (together with transversalis fascia) and non-absorbable for the linea alba. The patients were followed up postoperatively, and for 6 months after discharge from the hospital in follow-up for the detection of the wound complications. RESULTS The mean age of patients in Group A was 40.9 ± 15.48 years, and 41.03 ± 14.73 in Group B. There were 25 males and 5 females in Group A and 23 males and 7 females in Group B. Closure time of incision was significantly lower in the mass closure group (P < 0.05). The postoperative complications in Group A was 20 % (Seroma-1 patient, infection-3, partial wound dehiscence-1, and hernia-1). In Group B, the overall complication rate was 36 % (Seroma-3 patients, infection-5, burst abdomen- 1, hernia- 2). CONCLUSIONS Mass closure method is better than the conventional layer closure for the midline laparotomy incision. KEYWORDS Laparotomy, Layered Closure, Midline Incision, Mass Closure, Suture Technique

scholarly journals Comparative study of wound sequlae in layer closure and retention closure of midline laparotomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3316
Author(s):  
Euvalingam D. ◽  
Sendhil Nathan
Keyword(s):  
Comparative Study ◽  
Outcome Measures ◽  
Wound Closure ◽  
Single Layer ◽  
Complication Rates ◽  
Closure Technique ◽  
Midline Laparotomy ◽  
Suture Group ◽  
Group A ◽  
Time Required

Background: Layered closure of the abdomen has been considered to be ideal until recently however single layer mass (retention) closure technique, in which all the layers of the abdominal wall are closed in single layer is being increasingly used by surgeons. We conducted this study to analyze outcome measures in patients in whom wound closure was done by retention closure and layered closure.Methods: This was a prospective comparative study in which 60 patients undergoing elective or emergency laparotomy were included on the basis of a predefined inclusion and exclusion criteria. In 30 cases (50%) layer closure was done whereas in remaining 30 (50%) patients retention closure technique was used. Major outcome measures studied were time required for wound closure and post-operative complications.Results: Out of 60 studied cases there were 42 (70%) males and 18 (30%) females with M: F ratio of 1: 0.42.The time required for closure in layered suture group (group A) was 26.76±3.36 whereas in case of retention closure suturing it was 19.36±4.35. The difference was found to be statistically highly significant (p<0.0001). The complications rates were found to be statistically significantly higher in layer suturing (Group A) as compared to retention suture group (Group B).Conclusions: We conclude that retention suturing is preferable as compared to layered suturing in patients undergoing midline laparotomy in terms of time required for closure of wound and post-operative complication rates.

scholarly journals A Prospective Study Comparing Continuous Versus Interrupted Suture Techniques in Midline Abdominal Wound Closure

2020 ◽  
Vol 18 (1) ◽  
pp. 63-66
Author(s):  
Shiv Vansh Bharti ◽  
Anup Sharma
Keyword(s):  
Wound Infection ◽  
Wound Closure ◽  
College Teaching ◽  
Wound Complications ◽  
Burst Abdomen ◽  
Midline Laparotomy ◽  
Abdominal Closure ◽  
Group A ◽  
Laparotomy Wound ◽  
Group B

Introduction: Wound closure after midline laparotomy is an essential part of surgery to produce a healthy and a strong scar. There is an alternative interrupted method of closure as compared to conventional continuous method of closure. Many comparative studies have shown different outcomes. So, we wanted to evaluate the outcome of different techniques in our setting. Aims: To compare the outcome of Interrupted abdominal closure and continuous abdominal closure in midline laparotomy wound. Methods: This was a prospective comparative study conducted in the Department of Surgery of Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal for a duration of 1 year. A total of 60 patients were selected randomly to receive either continuous or interrupted abdominal closure in midline laparotomy wound. Wound was evaluated in terms of wound discharge, infection and wound dehiscence. Results: The mean age of the patients was 38.38 years. Most commonly, the patients presented with duodenal ulcer perforation with peritonitis. The average time taken for abdomen closure in group A (16.77 minutes) was significantly less as compared to group B (27.77 minutes). The average cost of sutures for group B (Rs 1322.97) was higher than that of sutures for group A (Rs 1118) with p value of <0.01. Wound infection and incidence of burst abdomen were similar in both groups after one month, suture sinus was seen in three patients of group A and four patients of group B (p = 1.0). Incisional hernia was seen in one patient of group A and in none of the patients of group B at three month’s follow-up (p = 1.0). Conclusion: Continuous technique of midline laparotomy wound closure is better in terms of time required for wound closure and costing of suture materials, while showing no difference in terms of wound infection, burst abdomen and late wound complications

COMPARATIVE STUDY BETWEEN MASS CLOSURE AND LAYERED CLOSURE OF MIDLINE ABDOMINAL INCISIONS AT DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 6-8
Author(s):  
Ravindra Kumar Ravi ◽  
Vijay Shankar Prasad ◽  
Debarshi Jana
Keyword(s):  
Incisional Hernia ◽  
Single Layer ◽  
Wound Dehiscence ◽  
Closure Technique ◽  
Burst Abdomen ◽  
True Incidence ◽  
Mass Closure ◽  
Time Required ◽  
Closure Group

Background: Traditionally, a laparotomy wound is closed in layers co-opting the various layers anatomically. A new method of closure, namely single layer closure technique (mass closure technique) has come into vogue. Aims: This study aims to evaluate the benets or otherwise between single layer closure and layered closure after comparing it with studies available in literature. Settings and Design : This study was conducted at Upgraded Department of Surgery, DMCH, Laheriasarai, Bihar, in patients undergoing laparotomy, either planned or emergency. Materials and Methods: A total of 80 cases were selected at random and the study was carried out over a period of 2 years. The cases were equally divided into two groups of 40. In both groups, vertical midline incision was used. In the rst group, abdomen was closed using the single layer closure technique. Continuous suturing with burial of the knots was done in 20 patients and interrupted mass closure was done in another 20 patients. In the other group, the abdomen was closed in layers. The patients were followed up for minimum 6 months. Patients who did not turn up for follow up were asked to notify the development of any wound complication through postal correspondence. Results: The time required for closure was considerably less when continuous suture technique was used. One patient in the mass closure group and four in the layered group developed post-operative wound infections. One patient in the layered closure group developed a stitch sinus. There were two cases of burst abdomen with the layered closure technique. Two patients in the layered closure group developed incisional hernias 6 months post-operatively. Conclusions: Single layer closure technique offers certain denite advantage over the layered closure technique with respect to the time required for closure of the incision, incidence of wound dehiscence and the incidence of incisional hernia. However, the true incidence of wound dehiscence (burst abdomen) and incisional hernia cannot be drawn since the study was of short duration and the number of cases was small without a long follow up.

Localization of Intracellular Antigens in thin Sections with Ferritin Labeled Antibody

1970 ◽  
Vol 28 ◽  
pp. 174-175
Author(s):  
M.S. Shahrabadi ◽  
T. Yamamoto
Keyword(s):  
Bovine Serum Albumin ◽  
Bovine Serum ◽  
Antigenic Determinants ◽  
Conjugate Prior ◽  
Thin Sections ◽  
Specific Attachment ◽  
Intracellular Antigen ◽  
Antigen Antibody ◽  
Ideal Method ◽  
The Ideal

The technique of labeling of macromolecules with ferritin conjugated antibody has been successfully used for extracellular antigen by means of staining the specimen with conjugate prior to fixation and embedding. However, the ideal method to determine the location of intracellular antigen would be to do the antigen-antibody reaction in thin sections. This technique contains inherent problems such as the destruction of antigenic determinants during fixation or embedding and the non-specific attachment of conjugate to the embedding media. Certain embedding media such as polyampholytes (2) or cross-linked bovine serum albumin (3) have been introduced to overcome some of these problems.

X-Ray Analysis of Frozen Hydrated Sections:The Unconventional Approach

1982 ◽  
Vol 40 ◽  
pp. 754-757
Author(s):  
R. Beeuwkes ◽  
A. Saubermann ◽  
P. Echlin ◽  
S. Churchill
Keyword(s):  
Ratio Method ◽  
Frozen Sections ◽  
Technical Problems ◽  
Sample Handling ◽  
X Ray ◽  
Common Group ◽  
Ideal Method ◽  
Classic Paper ◽  
Physical Principles ◽  
The Ideal

Fifteen years ago, Hall described clearly the advantages of the thin section approach to biological x-ray microanalysis, and described clearly the ratio method for quantitive analysis in such preparations. In this now classic paper, he also made it clear that the ideal method of sample preparation would involve only freezing and sectioning at low temperature. Subsequently, Hall and his coworkers, as well as others, have applied themselves to the task of direct x-ray microanalysis of frozen sections. To achieve this goal, different methodological approachs have been developed as different groups sought solutions to a common group of technical problems. This report describes some of these problems and indicates the specific approaches and procedures developed by our group in order to overcome them. We acknowledge that the techniques evolved by our group are quite different from earlier approaches to cryomicrotomy and sample handling, hence the title of our paper. However, such departures from tradition have been based upon our attempt to apply basic physical principles to the processes involved. We feel we have demonstrated that such a break with tradition has valuable consequences.

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