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Randomised prospective study of abdominal wall closure in patients with gynaecological cancer
Author(s) -
BERRETTA Roberto,
ROLLA Martino,
PATRELLI Tito Silvio,
PIANTELLI Giovanni,
MERISIO Carla,
MELPIGNANO Mauro,
NARDELLI Giovanni B.,
MODENA Alberto Bacchi
Publication year - 2010
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2010.01194.x
Subject(s) - medicine , incisional hernia , surgery , fascia , fibrous joint , laparotomy , hernia , wound dehiscence , abdominal wall , dehiscence , prospective cohort study , abdomen , polydioxanone
Background: Median laparotomy is the most common approach to the abdominopelvic cavity in patients with gynaecological tumours. Aims: The primary endpoint of the study was to evaluate the onset of incisional hernia. The secondary endpoint was to evaluate the onset of infection, wound dehiscence, wound infection, and scar pain during the post‐operative period. Methods: A total of 191 patients were eligible for the study. They were divided into three groups. Group A underwent en bloc closure of the peritoneum and fascia with Premilene® suture, Group B en bloc closure of the peritoneum and fascia with Polydioxanone suture, and Group C separate closure of the peritoneum and fascia with single stitches of Ethibond suture. Statistical analysis was performed using the Statistical Software Package for Social Sciences 12.0. Results: Group A and Group B comprised 63 patients, and Group C included 65 patients. The three groups proved homogeneous on statistical analysis ( P > 0.05). The statistical analysis did not reveal significant differences between the different suture types and techniques with respect to the incidence of incisional hernia ( P > 0.05). Conclusion: In our study, the incidence of incisional hernia was 8%. Randomised patients were homogeneous for sample size and risk factors. No significant differences were found between suture types or techniques. Currently, there is no suture material or technique that can be considered superior to others. When possible, we believe that the best way to prevent incisional hernia is to preserve the integrity of the abdominal wall using minimally invasive techniques.