Jing Zhang1,2,3, Hong-Ke Zhang1,2,3, Hao-Yang Zhu1,2,3, Jian-Wen Lu1,2,3, Qiang Lu1,2,3, Yi-Fan Ren1,2,3, Chang Liu1,2,3, Jian Dong1,2,3, Zhao-Qing Du1,2,3, Xue-Min Liu1,2,3, Zheng Wu1,2,3, Yi Lv4,5,6, Xu-Feng Zhang7,8,9. 1. Department of Hepatobiliary Surgery, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. 2. Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. 3. Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. 4. Department of Hepatobiliary Surgery, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. luyi169@126.com. 5. Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. luyi169@126.com. 6. Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. luyi169@126.com. 7. Department of Hepatobiliary Surgery, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. xfzhang125@126.com. 8. Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. xfzhang125@126.com. 9. Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, No. 277 West Yan-ta Road, Xi'an, 710061, Shaanxi, People's Republic of China. xfzhang125@126.com.
Abstract
BACKGROUND: Abdominal incision closure technique seriously influences patient prognosis. Most studies have focused on the different suture techniques and materials on midline incision, while little data are available in wide transverse or oblique incisions after liver resection (LR). The aim of the present study is to compare the two major incision suture methods after LR in our institute: Mass continuous suture (group P) and layered interrupted suture (group S). STUDY DESIGN: 258 patients undergoing LR with abdominal transverse or oblique incisions were prospectively enrolled. They were divided into two groups according to different abdominal incision suture methods and compared with the preoperative, intraoperative parameters, and postoperative wound complications. RESULTS: There were 118 patients in group P and 140 patients in group S, which was similar in general condition, primary disease, liver, and renal function. Incision length, total operation time, intraoperative blood loss, or perioperative antibiotics use were not different between the two groups. However, abdominal incision closure time and interval time for stitches removing after operation was significantly shorter in group P than group S (both p < 0.001). After a median follow-up of 16 months, the incidence of wound infection and fat liquefaction was more than two times higher in group S than group P, which, however, was not statistically different. Moreover, there was no difference in wound disruption or incisional hernia between the two groups. CONCLUSIONS: Although similar in occurrence of postoperative wound complications, mass continuous suture with polydioxanone seemed to be more timesaving in incision closure and motivated in wound healing.
BACKGROUND: Abdominal incision closure technique seriously influences patient prognosis. Most studies have focused on the different suture techniques and materials on midline incision, while little data are available in wide transverse or oblique incisions after liver resection (LR). The aim of the present study is to compare the two major incision suture methods after LR in our institute: Mass continuous suture (group P) and layered interrupted suture (group S). STUDY DESIGN: 258 patients undergoing LR with abdominal transverse or oblique incisions were prospectively enrolled. They were divided into two groups according to different abdominal incision suture methods and compared with the preoperative, intraoperative parameters, and postoperative wound complications. RESULTS: There were 118 patients in group P and 140 patients in group S, which was similar in general condition, primary disease, liver, and renal function. Incision length, total operation time, intraoperative blood loss, or perioperative antibiotics use were not different between the two groups. However, abdominal incision closure time and interval time for stitches removing after operation was significantly shorter in group P than group S (both p < 0.001). After a median follow-up of 16 months, the incidence of wound infection and fat liquefaction was more than two times higher in group S than group P, which, however, was not statistically different. Moreover, there was no difference in wound disruption or incisional hernia between the two groups. CONCLUSIONS: Although similar in occurrence of postoperative wound complications, mass continuous suture with polydioxanone seemed to be more timesaving in incision closure and motivated in wound healing.
Authors: Kai A Bickenbach; Paul J Karanicolas; John B Ammori; Shiva Jayaraman; Jordan M Winter; Ryan C Fields; Anand Govindarajan; Itzhak Nir; Flavio G Rocha; Murray F Brennan Journal: Am J Surg Date: 2013-04-06 Impact factor: 2.565