CLINICAL INVESTIGATION OF INCISIONAL HERNIA FOLLOWING RUNNING MASS CLOSURE OF THE ABDOMEN USING ABSORBABLE SYNTHETIC MONOFILAMENT LOOPED SUTURES

A prospective comparative study of layered closure versus mass closure of vertical midline laparotomy incisions was undertaken in 314 consecutive patients of indigenous Negroid ancestry. Group A (109 patients) had mass closure and group B (205 patients) had layered closure. The patients were similar in both groups. Group A consisted of 49 (45%) emergencies and 60 (55%) elective cases, and group B of 93 (45%) emergencies and 112 (55%) elective cases. There were 6 cases of burst abdomen and 4 cases of incisional hernia in group B; group A suffered no wound failure. The wound infection rates were 3.7% for group A and 10% for group B. Mass closure carries lower wound failure rates than layered closure of laparotomy wounds, and polyamide sutures do not increase keloid formation in Negro patients.

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Comparative Study between Mass Closure and Hughes Repair in Emergency Laparotomy

QJM ◽

10.1093/qjmed/hcaa050.057 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

E F Ebied ◽

A A Khalil ◽

A M Soliman

Keyword(s):

Incisional Hernia ◽

Comparative Study ◽

Wound Infection ◽

Operation Time ◽

Exploratory Laparotomy ◽

The Body ◽

Emergency Laparotomy ◽

Mass Closure ◽

Wound Pain ◽

Major Factors

Abstract Background Exploratory laparotomy remains one of the common operations across the surgical disciplines. As such, the systematic and safe closure of such a laparotomy wound is the key to reduce the postoperative morbidity like wound pain, wound infection and incisional hernia. Objective To compare mass closure & Hughes repair in emergency laparotomy as regard intraoperative technique, operation time, incidence of complication as wound infection, dehiscence, burst abdomen and incisional hernia. Patients and Methods This is a prospective comparative study between two types of closure, mass closure and hughes repair in emergency laparotomies. This study was conducted at Ain-Shams University Emergency Hospitals. Patients who underwent emergency laprotomy from September 2017 to March 2018 and the patients were followed up postoperatively for six months. All patients who underwent emergency laparotomy at Ain-Shams University Emergency Hospitals from September 2017 to March 2018 were chosen according to inclusion and exclusion criteria. Results In this study we used the same suture and materials” Polydioxanone PDS loop 1”. The comparative study included several items to discuss starting from the time of the technique in our study it ranged from 12 -19 minutes in the conventional method “Mass closure” and it ranged from 24-31 minutes in the huge repair group. It was observed that the length of the laprotomy incision determine the time of the technique. The overall operative time of mass closure group was shorter than the hughe repair technique Conclusion It was observed that there were major factors that affected the results such as the reason for the laparotomy and the general condition of the patient especially the chest condition, diabetes mellitus, serum albumin, anemia and the body mass index.

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Incisional hernia after mass closure of abdominal incisions with dexon and prolene

British Journal of Surgery ◽

10.1002/bjs.1800690118 ◽

1982 ◽

Vol 69 (1) ◽

pp. 55-55 ◽

Cited By ~ 17

Author(s):

C. D. Johnson ◽

L. W. Bernhardt ◽

P. G. Bentley

Keyword(s):

Incisional Hernia ◽

Mass Closure

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A post-market, prospective, multi-center, single-arm clinical investigation of Phasix™ mesh for VHWG grade 3 midline incisional hernia repair: a research protocol

BMC Surgery ◽

10.1186/s12893-018-0439-7 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

M. M. J. van Rooijen ◽

A. P. Jairam ◽

T. Tollens ◽

L. N. Jørgensen ◽

T. S. de Vries Reilingh ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Clinical Investigation ◽

Incisional Hernia Repair ◽

Research Protocol ◽

Post Market ◽

Grade 3

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P111 HIGH RATE OF INCISIONAL HERNIA AFTER MASS CLOSURE OF BURST ABDOMEN

British Journal of Surgery ◽

10.1093/bjs/znab395.104 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Thomas Korgaard Jensen ◽

Ismail Gögenur ◽

Mai-Britt Tolstrup

Keyword(s):

Incisional Hernia ◽

High Rate ◽

Fascial Closure ◽

Closure Technique ◽

Burst Abdomen ◽

Incisional Hernias ◽

Mass Closure ◽

Long Term Effect

Abstract Aim This study investigated the long-term effect of a standardized strategy of fascial closure with a mass closure technique, using a slowly absorbable running stitch for burst abdomen and evaluated the incidence of incisional hernia in these patients. Material and Methods A single-center, retrospective study including all patients that underwent surgery for burst abdomen between June 2014 and April 2019 was followed up in October 2020 to report the rate of incisional hernias. Results 94 patients underwent surgery for burst abdomen. 80 patients was enrolled for follow up. Index surgery was acute in 78%. Incisional hernia rate was 33%. 30-day mortality rate was 24%. Conclusions Standardized surgery for burst abdomen with a standardized mass-closure technique still results in high rates of incisional hernias.

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

10.36106/5232162 ◽

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.

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