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01-08-2020 | Laparotomy | Original Article

Implementation of the small bites closure of abdominal midline incisions in clinical practice is correlated with a reduction in surgical site infections

Authors: H. S. de Vries, T. Verhaak, T. H. van Boxtel, W. van den Heuvel, M. B. Teixeira, J. Heisterkamp, D. D. E. Zimmerman

Published in: Hernia | Issue 4/2020

Abstract

Background

Small steps wound closure of midline laparotomy has been reported to decrease the incidence of incisional hernia development in two randomized controlled trials. The aim of the present study was to evaluate the effect of implementing the small steps wound closure technique in clinical practice with regards to the development of incisional ventral hernia (IVH) and surgical site infections (SSI) in clinical practice.

Methods

Implementation of the small steps wound closure technique using the small tissue bites technique as the standard closure technique for abdominal midline incisions in our clinical practice was done in March 2015. For this study, all patients from June 2013 until June 2016 with a midline laparotomy, either long or small in case of specimen extraction in laparoscopic surgery, in either elective or emergency setting were included. Conventional large bite wound closure was compared to small steps wound closure with regards to the development of SSI, IVH as well as burst abdomen.

Results

A total of 327 patients were included. The small steps suture technique was used in 136 (42%) of the patients, whereas the conventional large bites suture technique was used in 191 patients (58%). A total of 54 patients in the large bites group developed SSI (28%) compared to 23 (17%) patients in the small steps group (p = 0.02). A total number of 10 patients (7%) developed IVH in the small steps group compared to 27 patients (14%) in the large bites group (p = 0.08).

Conclusion

Implementation of small bites wound closure of abdominal midline incisions in clinical practice was correlated with a reduction in surgical site infections.

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Title: Implementation of the small bites closure of abdominal midline incisions in clinical practice is correlated with a reduction in surgical site infections
Authors: H. S. de Vries
T. Verhaak
T. H. van Boxtel
W. van den Heuvel
M. B. Teixeira
J. Heisterkamp
D. D. E. Zimmerman
Publication date: 01-08-2020
Publisher: Springer Paris
Keywords: Laparotomy
Wound Infection
Laparotomy
Incision
Incisional Hernia
Published in: Hernia / Issue 4/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-01995-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Implementation of the small bites closure of abdominal midline incisions in clinical practice is correlated with a reduction in surgical site infections

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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