PP 104 Prevention of Surgical Site Infection by Optimizing Abdominal Fascia Closure Techniques


V. Samartsev, V. Gavrilov, A Kuchumov, A Sergeev

17:54 - 18:00h at Margrit Room

Categories: Cardiac and Vascular Surgery, Poster Session

Session: Poster II (P2) - Cardiac & Vascular Surgery / Inflammation & Wound Healing


Background
The aim of our studies was to advance abdominal wall closure technique with absorbable suture materials with antibacterial coating.

Material and Methods
Mechanical and rheological properties of the surgery suture material were used for the biomechanical modeling and mathematic analysis of continuous and interrupted sutures by developing virtual biomechanical model of abdominal wall. The calculated experimental parameters of the abdominal wall closure were studied on the biological model of rats. Regenerative changes of the aponeurosis samples with different suture materials were morphologically evaluated. 293 patients with midline incisions of abdominal wall were included into the studying. 67 of them - midline abdominal fascia was closured with a simple continuous suture with a triclosan-coated loop suture PDS Plus, a continuous suture to the adipose tissue with Vicryl Plus and continuous intracutaneous suture with Monocryl Plus. The obtained data were compared with retrospective studies of 226 patients operated for the similar pathology with operative wounds closed with interrupted sutures using capron.

Results
Using a virtual mechanical model of abdominal wall shows efficiency of simply continuous suture in fascial closure. In group 2 of laboratory rats post-operative wounds were epithelized at the cutaneous level. Aponeuroses were almost completely restored. In the observed group no post-operative herniations were observed after 12 months after operation. After 12 months in the comparative group 13 of 226 cases were diagnosed with incision hernias.

Conclusion
Suturing of the anterior abdominal wall with the simple continuous suture using synthetic absorbable suture material has allowed to decrease the rate of late postoperative complications.