Abdominal Wall Closure In The Presence Of Sepsis: Role Of Negative Suction

10.5580/2d01 ◽  
2013 ◽  
Vol 29 (1) ◽  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Closure ◽  
Negative Suction

scholarly journals A prospective study in peritonitis patients to compare the impact of subcutaneous negative suction closure, conventional primary closure of skin and subcutaneous tissue and open skin technique following laparotomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3293
Author(s):  
Mano Zac Mathews ◽  
Sriram Gopalakrishnaiah Subramanyam ◽  
Nivedita Mitta
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Suction Drain ◽  
Group A ◽  
Group B ◽  
Negative Suction

Background: Abdominal wall closure in the presence of sepsis presents a challenge to the surgeon. The objective of this study is to determine the advantages and disadvantages of each method to individualise the techniques based on patient profile about surgical site infection, duration of hospitalisation and morbidity.Methods: A prospective comparative study was conducted among 102 operated patients of peritonitis in the Department of General Surgery at St John’s Medical College and Hospital. The patients were divided into three groups, group A, group B and group C. In group A, skin and subcutaneous tissue was closed after draining the subcutaneous space by a negative-suction drain. In group B, the patient’s skin and subcutaneous tissues were closed primarily with continuous sutures without negative suction drain. In group C, the laparotomy wound was closed and the skin was left open. And the outcome compared in the form of wound infection, hospital stay and morbidity. Patients on immunosuppressive therapy and paediatric patients were excluded. Demographic and clinical variables were recorded at the time of admission. SPSS version 18 was used for analysis.Results: The study showed male preponderance and the mean age was 43.2 years. Duodenal perforation was the commonest cause of peritonitis in this study (38.2%). Incidence of surgical site infection was less in Group A (20.6%) compared to group B (52.9%) and group C (29.4%). Duration of hospital stay was also less in Group A patients (9.3±3.6 days) compared to other two groups. 37 patients who were included in the study were diabetic, out of which 25 patients (67.6%) developed surgical site infection.Conclusions: It can be concluded from this study that abdominal wall closure using a sub cutaneous negative suction drain in peritonitis cases reduces the incidence of surgical site infection, duration of hospital stays, subsequent surgeries related to wound dehiscence and its associated morbidity.  

scholarly journals Abdominal wall closure in the presence of sepsis (acute abdomen): role of negative suction

2018 ◽  
Vol 5 (2) ◽  
pp. 407
Author(s):  
Thrishuli P. B. ◽  
Pavan Kumar E.
Keyword(s):  
Abdominal Wall ◽  
Wound Dehiscence ◽  
Drainage Tube ◽  
Suction Drainage ◽  
Abdominal Wall Closure ◽  
Suction Drain ◽  
Group A ◽  
Group B ◽  
Closure Group ◽  
Negative Suction

Background: To compare and find out the best method of abdominal wall closure in cases peritonitis between subcutaneous negative suction drainage tube and conventional primary skin and subcutaneous closure.Methods: From September 2015 to September 2017, 100 patients who presented at the emergency department with acute abdominal pain and operated for the same, with features s/o peritonitis were enrolled into the study. 50 of them were managed with subcutaneous negative suction drainage tube during abdominal wall closure (Group A). 50 other patients underwent conventional method of abdominal wall closure (Group B). On table pus c/s was sent for all 100 cases. The surgical wound was observed for signs of infection. Any seropurulent collection from the drain or any discharge from the wound was sent for c/s and the results of which were compared with the results of on table pus c/s. If wound dehiscence was noted, secondary suturing was done after the wound healed. The duration of suction drain placement and stay in the hospital were noted in all cases. The results were analyzed with Chi-square test and Student t test (unpaired) and p values were calculated. A p value of less than 0.05 was considered significant.Results: The incidence of SSI was significantly less in Group A (20%) than in Group B (64%). Similarly, wound dehiscence occurred in 30% of SSI cases in Group A as against 87.1% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (8 days).Conclusions: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay.

Chemotherapy and Abdominal Wall Closure Technique Increase the Probability of Postoperative Ventral Incisional Hernia in Patients With Colon Cancer

2021 ◽  
pp. 000313482110111
Author(s):  
David A. Santos ◽  
Liangliang Zhang ◽  
Kim-Anh Do ◽  
Brian K. Bednarski ◽  
Celia Robinson Ledet ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Suture Technique ◽  
Abdominal Wall Closure ◽  
Clinical Predictors ◽  
Closure Technique ◽  
Ventral Incisional Hernia

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.

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

2010 ◽  
Vol 113 (1) ◽  
pp. 79-81 ◽  
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.

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

Hernia ◽  
2017 ◽  
Vol 21 (6) ◽  
pp. 873-877 ◽  
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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