Choosing the best abdominal closure by meta-analysis.

Abstract:

BACKGROUND:Local custom, rather than evidence-based medicine, dictates how a surgeon closes abdominal wounds. Closures might be more secure if grounded on statistical data. MATERIALS AND METHODS:A meta-analysis of 12,249 patients with abdominal wound closures was made. Infections, hernias, and dehiscences were compared examining continuous versus interrupted closures, continuous (absorbable versus nonabsorbable), interrupted (absorbable versus nonabsorbable), and mass versus layered. RESULTS:Continuous absorbable closures showed more hernias (P = 0.0007). Dehiscences were significantly more with continuous nonabsorbable suture (P = 0.01). Interrupted nonabsorbable closures showed a higher incidence of hernias and dehiscences (P = 0.0002, P = 0.04). Mass closures produced significantly less hernias and dehiscences when compared with layered closures (P = 0.02, P = 0.0002). CONCLUSIONS:Continuous closures with nonabsorbable suture should be used to close most abdominal wounds. However, if infection or distention is anticipated, interrupted absorbable sutures are preferred. Mass closures are superior to layered closures.

journal_name

Am J Surg

authors

Weiland DE,Bay RC,Del Sordi S

doi

10.1016/s0002-9610(98)00277-3

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

666-70

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(98)00277-3

journal_volume

176

pub_type

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