Abstract

Abstract Introduction Evisceration is a frequent consequence after performing midline laparotomies (ML) in urgent abdominal surgeries. The aim of this study was to compare and evaluate the results obtained after the introduction of barbed sutures in abdominal wall closure. Materials and methods We performed a retrospective analysis of patients undergoing emergency surgery in our hospital following a midline laparotomy approach in the last 5 years. Preoperative variables were compared between both groups and related to early surgical wound complications, depending on the type of abdominal wall closure performed. Results 222 patients underwent surgery (Polydioxanone (P); 128; Barbed (B); 94) after ruling out exclusion factors such as neuromuscular disease, recent abdominal surgeries and whose follow-up had been lost. There were no significant differences between the two groups in terms of preoperative baseline characteristics or associated comorbidities. Furthermore, there were no statistically significant differences in type of surgery performed; the most frequent was small bowel obstruction. After data analysis, no differences were found in terms of hospital stay (P; 7.43 days vs B; 6.05 days, p=0.421) or mortality (P; 3.125% vs B; 4.25, p=0.655). Concerning immediate complications, there were no differences regarding surgical wound infection (P; 18.75% vs B; 10.63%, p=0.061) and seroma (P; 3.125% vs B; 2.12, p=0.651). Evisceration rates turned out to be more frequent in the polydioxanone group (P; 20.31% vs B; 8.51%, p=0.016). Conclusions The use of barbed sutures reduced the incidence of evisceration, therefore it can be considered as recommended sutures for aponeurotic closure in emergent ML.

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