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Incisional hernia after laparotomy: prospective randomized comparison between early-absorbable and late-absorbable suture materials.

Abstract：

:Incisional hernia is a serious postoperative complication of laparotomy. Selecting an appropriate suture material may lessen such morbidity. This study undertook a prospective, randomized comparison of early-absorbable polyglactin 910 suture versus late-absorbable polydioxanone loop suture for fascial closure after abdominal surgery. A series of 340 consecutive patients undergoing elective laparotomy were randomized to have fascial closure with either polyglactin 910 suture or polydioxanone loop suture between October 1993 and August 1996. A 2-year follow-up revealed that 23 patients had died, and the overall mortality rate was 6.8% (23/340). Ten (10/340, 2.9%) patients, including seven with polyglactin 910 suture and three with polydioxanone loop suture, developed incisional hernias. The early postoperative evaluation revealed an incidence of wound infection of 4.1% (14/340). The development of incisional hernia was not secondary to postoperative wound infection in this study. Among these 340 patients, 192 had malignant diseases and 148 had nonmalignant ones. Fascial closure with polyglactin 910 suture was associated with more incisional hernias than that with polydioxanone loop suture, with marginal significance for patients in the malignant group (4.7% versus 0%, p = 0.07) but not in the nonmalignant group (2.6% versus 4.2%, p = 0.67). In conclusion, abdominal closure with a late-absorbable polydioxanone loop suture may be beneficial to patients with a malignant disease for preventing incisional hernia.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Hsiao WC,Young KC,Wang ST,Lin PW

doi

10.1007/s002689910120

keywords:

subject

Has Abstract

pub_date

2000-06-01 00:00:00

pages

747-51; discussion 752

issue

6

eissn

0364-2313

issn

1432-2323

pii

10.1007/s002689910120

journal_volume

24

pub_type

临床试验,杂志文章,随机对照试验

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