BARBED SUTURE FOR LAPAROTOMY CLOUSURE IN URGENCY PROCEDURES. RETROSPECTIVE ANALYSIS

Abstract

Abstract INTRODUCTION Urgency surgeries are often performed in a stressful setting, out of hours and with critical patient involved. In this context, laparotomy closure can sometimes be deficient. Suture recommended by European Hernia Society is slowly absorbable monofilament continuous suture with a “small bites” technique. Barbed sutures appear as an alternative to conventional suture, frequently used in laparoscopic procedures due to its’ intrinsic maintenance of traction. The aim of this study is to describe the results in terms of short and mid-term rate of incisional hernia after urgency midline laparotomy, according to the suture utilized. MATERIAL AND METHODS A single-center retrospective cohort study was performed including patients with urgency midline laparotomy during 2018. Group A was represented by patients with slowly absorbable monofilament continuous suture. Group B included patients with barbed suture laparotomy closure. Main variables were hernia rates one month and one year after surgery, diagnosed by physical exploration and/or imaging. RESULTS A total of 68 of patients (36 on group A; 32 Group B) were included. On Group A, 13.9% (5) patients presented incisional hernia on the month follow-up, whereas none did on Group B. After a year, Group A only had 1 new case, but 12.5% of patients did herniate on group B; with no significantly relation with obesity neither underlying neoplasm. CONCLUSIONS Midline laparotomy closure must be performed within quality standards, as “small bites” technique with the ratio at least 4/1. Barbed suture appears as a promising closure option, especially in emergency procedures, but needs further study.