Skip to main content
Top
Published in: World Journal of Surgery 10/2018

01-10-2018 | Original Scientific Report

A New Method for Surgical Abdominal Mass Closure After Abdominal Fascial Dehiscence Using Nasogastric Tube and Hemovac Perforator: A Case-Series Study

Authors: Jalal Vahedian, Sepideh Jahanian, Behrouz Banivaheb, Nima Hemmati, Mehrnaz Ghavamipour, Majid Chegini, Mahdi Alemrajabi

Published in: World Journal of Surgery | Issue 10/2018

Login to get access

Abstract

Background

As the challenge for finding the best abdominal incision closure technique continues, surgeons are aiming to minimize postoperative wound complications such as wound dehiscence and hernia as an acute or late manifestation. In order to achieve this goal, several abdominal opening and closure techniques have been tried. In this article, we describe a method in which we used a nasogastric tube (NGT) in mass closure for patients with fascial dehiscence.

Methods

In this case-series study, a total number of 25 patients participated. All of the patients had abdominal dehiscence after a surgery and had to undergo for another. An NGT was used for abdominal closure. The patients were followed for a month and were examined for any signs and symptoms of fever, infection, pain, material expenses, closing time, and laboratory data. The data were analyzed using SPSS software V.22. Mean ± SD and frequencies were used for describing the variables.

Results

The mean NGT mass closure material expenses for each patient were 8400.00 ± 0.00 IRR (around 0.25 US dollars). The mean closure time after the operation was 13.08 ± 3.09 min. There was no evidence of infection among the patients as well as no other complications after the surgery in the 1-month study period.

Conclusion

Abdominal mass closure with NG tube suturing technique is associated with reduced time required for closure of the incision, incidence of wound dehiscence, and the incidence of incisional hernia as well as infection, with a considerable low cost.
Literature
1.
go back to reference Webster C, Neumayer L, Smout R, Horn S, Daley J, Henderson W et al (2003) Prognostic models of abdominal wound dehiscence after laparotomy. J Surg Res 109(2):130–137CrossRefPubMed Webster C, Neumayer L, Smout R, Horn S, Daley J, Henderson W et al (2003) Prognostic models of abdominal wound dehiscence after laparotomy. J Surg Res 109(2):130–137CrossRefPubMed
2.
go back to reference Bloemen A, van Dooren P, Huizinga BF, Hoofwijk AG (2011) Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure. Br J Surg 98(5):633–639CrossRefPubMed Bloemen A, van Dooren P, Huizinga BF, Hoofwijk AG (2011) Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure. Br J Surg 98(5):633–639CrossRefPubMed
3.
go back to reference Kenig J, Richter P, Lasek A, Zbierska K, Zurawska S (2014) The efficacy of risk scores for predicting abdominal wound dehiscence: a case-controlled validation study. BMC Surg 14:65CrossRefPubMedPubMedCentral Kenig J, Richter P, Lasek A, Zbierska K, Zurawska S (2014) The efficacy of risk scores for predicting abdominal wound dehiscence: a case-controlled validation study. BMC Surg 14:65CrossRefPubMedPubMedCentral
4.
go back to reference Kim JJ, Liang MK, Subramanian A, Balentine CJ, Sansgiry S, Awad SS (2011) Predictors of relaparotomy after nontrauma emergency general surgery with initial fascial closure. Am J Surg 202(5):549–552CrossRefPubMed Kim JJ, Liang MK, Subramanian A, Balentine CJ, Sansgiry S, Awad SS (2011) Predictors of relaparotomy after nontrauma emergency general surgery with initial fascial closure. Am J Surg 202(5):549–552CrossRefPubMed
6.
go back to reference van Ramshorst GH, Eker HH, van der Voet JA, Jeekel J, Lange JF (2013) Long-term outcome study in patients with abdominal wound dehiscence: a comparative study on quality of life, body image, and incisional hernia. J Gastrointest Surg 17(8):1477–1484CrossRefPubMed van Ramshorst GH, Eker HH, van der Voet JA, Jeekel J, Lange JF (2013) Long-term outcome study in patients with abdominal wound dehiscence: a comparative study on quality of life, body image, and incisional hernia. J Gastrointest Surg 17(8):1477–1484CrossRefPubMed
7.
go back to reference Yılmaz KB, Akıncı M, Doğan L, Karaman N, Özaslan C, Atalay C (2013) A prospective evaluation of the risk factors for development of wound dehiscence and incisional hernia. Turk J Surg 29(1):25–30 Yılmaz KB, Akıncı M, Doğan L, Karaman N, Özaslan C, Atalay C (2013) A prospective evaluation of the risk factors for development of wound dehiscence and incisional hernia. Turk J Surg 29(1):25–30
8.
go back to reference Riou JP, Cohen JR, Johnson H Jr (1992) Factors influencing wound dehiscence. Am J Surg 163(3):324–330CrossRefPubMed Riou JP, Cohen JR, Johnson H Jr (1992) Factors influencing wound dehiscence. Am J Surg 163(3):324–330CrossRefPubMed
9.
go back to reference van’t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J (2002) Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg 89(11):1350–1356CrossRef van’t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J (2002) Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg 89(11):1350–1356CrossRef
10.
go back to reference Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C et al (2009) Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg 249(4):576–582CrossRefPubMed Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C et al (2009) Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg 249(4):576–582CrossRefPubMed
11.
go back to reference Gislason H, Viste A (1999) Closure of burst abdomen after major gastrointestinal operations–comparison of different surgical techniques and later development of incisional hernia. Eur J Surg 165(10):958–961CrossRefPubMed Gislason H, Viste A (1999) Closure of burst abdomen after major gastrointestinal operations–comparison of different surgical techniques and later development of incisional hernia. Eur J Surg 165(10):958–961CrossRefPubMed
12.
go back to reference Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM (2010) Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg 251(5):843–856CrossRefPubMed Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM (2010) Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg 251(5):843–856CrossRefPubMed
13.
go back to reference Chawla S (2012) A comparison between mass closure and layered closure of midline abdominal incisions. Med J Dr DY Patil Univ 5(1):26–27 Chawla S (2012) A comparison between mass closure and layered closure of midline abdominal incisions. Med J Dr DY Patil Univ 5(1):26–27
14.
go back to reference Chalya PL, Massinde AN, Kihunrwa A, Mabula JB (2015) Abdominal fascia closure following elective midline laparotomy: a surgical experience at a tertiary care hospital in Tanzania. BMC research notes 8 Chalya PL, Massinde AN, Kihunrwa A, Mabula JB (2015) Abdominal fascia closure following elective midline laparotomy: a surgical experience at a tertiary care hospital in Tanzania. BMC research notes 8
15.
go back to reference Srivastava A, Roy S, Sahay K, Seenu V, Kumar A, Chumber S et al (2004) Prevention of burst abdominal wound by a new technique: a randomized trial comparing continuous versus interrupted X-suture. Indian J Surg 66(1):19 Srivastava A, Roy S, Sahay K, Seenu V, Kumar A, Chumber S et al (2004) Prevention of burst abdominal wound by a new technique: a randomized trial comparing continuous versus interrupted X-suture. Indian J Surg 66(1):19
16.
go back to reference Koniaris LG, Hendrickson RJ, Drugas G, Abt P, Schoeniger LO (2001) Dynamic retention: a technique for closure of the complex abdomen in critically ill patients. Arch Surg (Chicago, Ill: 1960) 136(12):1359–1362 (discussion 63) CrossRef Koniaris LG, Hendrickson RJ, Drugas G, Abt P, Schoeniger LO (2001) Dynamic retention: a technique for closure of the complex abdomen in critically ill patients. Arch Surg (Chicago, Ill: 1960) 136(12):1359–1362 (discussion 63) CrossRef
17.
go back to reference Gäddnäs F, Saarnio J, Ala-Kokko T, Laurila J, Koivukangas V (2007) Continuous retention suture for the management of open abdomen: a high rate of delayed fascial closure. Scand J Surg 96(4):301–307CrossRefPubMed Gäddnäs F, Saarnio J, Ala-Kokko T, Laurila J, Koivukangas V (2007) Continuous retention suture for the management of open abdomen: a high rate of delayed fascial closure. Scand J Surg 96(4):301–307CrossRefPubMed
18.
go back to reference Gupta H, Srivastava A, Menon GR, Agrawal CS, Chumber S, Kumar S (2008) Comparison of interrupted versus continuous closure in abdominal wound repair: a meta-analysis of 23 trials. Asian J Surg 31(3):104–114CrossRefPubMed Gupta H, Srivastava A, Menon GR, Agrawal CS, Chumber S, Kumar S (2008) Comparison of interrupted versus continuous closure in abdominal wound repair: a meta-analysis of 23 trials. Asian J Surg 31(3):104–114CrossRefPubMed
19.
go back to reference Aminpour M, Alamrajabi M, Movahhed M, Fereshtehnejad S (2009) Report of a case of open abdomen using zipper locked method. Razi J Med Sci 16(62):53–58 Aminpour M, Alamrajabi M, Movahhed M, Fereshtehnejad S (2009) Report of a case of open abdomen using zipper locked method. Razi J Med Sci 16(62):53–58
20.
go back to reference Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C et al (2009) Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg 249(4):576–582CrossRefPubMed Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C et al (2009) Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg 249(4):576–582CrossRefPubMed
21.
go back to reference Ceydeli A, Rucinski J, Wise L (2005) Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg 62(2):220–225CrossRefPubMed Ceydeli A, Rucinski J, Wise L (2005) Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg 62(2):220–225CrossRefPubMed
22.
go back to reference Komba CO (2012) Practices of abdominal fascial closure and related complications following elective midline laparotomy at Muhimbili National Hospital: Muhimbili University of Health and Allied Sciences Komba CO (2012) Practices of abdominal fascial closure and related complications following elective midline laparotomy at Muhimbili National Hospital: Muhimbili University of Health and Allied Sciences
24.
go back to reference Bucknall T, Teare L, Ellis H (1983) The choice of a suture to close abdominal incisions. Eur Surg Res 15(2):59–66CrossRefPubMed Bucknall T, Teare L, Ellis H (1983) The choice of a suture to close abdominal incisions. Eur Surg Res 15(2):59–66CrossRefPubMed
25.
go back to reference Osterberg B (1982) Enclosure of bacteria within capillary multifilament sutures as protection against leukocytes. Acta Chir Scand 149(7):663–668 Osterberg B (1982) Enclosure of bacteria within capillary multifilament sutures as protection against leukocytes. Acta Chir Scand 149(7):663–668
Metadata
Title
A New Method for Surgical Abdominal Mass Closure After Abdominal Fascial Dehiscence Using Nasogastric Tube and Hemovac Perforator: A Case-Series Study
Authors
Jalal Vahedian
Sepideh Jahanian
Behrouz Banivaheb
Nima Hemmati
Mehrnaz Ghavamipour
Majid Chegini
Mahdi Alemrajabi
Publication date
01-10-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 10/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4607-9

Other articles of this Issue 10/2018

World Journal of Surgery 10/2018 Go to the issue