A retrospective analysis of early and late term complications in patients who underwent application of retention sutures for gastrointestinal tract malignancies
Barış Bayraktar1, İbrahim Ali Özemir1, Julide Sağıroğlu1, Gökhan Demiral2, Yahya Çelik3, Sinan Aslan1, Ercüment Tombalak1, Ahmet Yılmaz4, Rafet Yiğitbaşı1
1Clinic of General Surgery, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
2Clinic of General Surgery, Ardahan State Hospital, Ardahan, Turkey
3Clinic of General Surgery, İslahiye State Hospital, Gaziantep, Turkey
4Department of General Surgery, İstanbul Medipol University, İstanbul, Turkey
Abstract
Objective: Complications associated with wound healing after abdominal tumor operations continue to be a significant problem. This study aimed to determine the significance of retention sutures in preventing these complications. For this purpose, early and late term results of patients who underwent application of polydioxanone (PDS) and additional retention sutures for abdominal closure were retrospectively evaluated.
Material and Methods: Clinical files of 172 patients who were operated due to gastrointestinal tract malignancies in our clinic between January 2007 and January 2011 were retrospectively analyzed. Patients in whom the fascia was repaired only with PDS (Group 1) were compared to patients in whom the fascia was repaired with PDS and retention sutures (Group 2) in terms of age, gender, postoperative evisceration-wound infection (<1 month)-incisional hernia (>1 month), incision type, co-morbid factors, and operative time.
Results: There was no significant difference between the two groups in terms of age or gender (p=0.680 and p=0.763). No significant difference was detected in terms of postoperative incisional hernia (p=0.064). Evisceration and post-operative wound infection were significantly lower in Group 2 as compared to Group 1 (p=0.008 and p=0.002). Operative time was significantly longer in Group 1 than in Group 2 (p<0.0001). Co-morbid features were significantly higher in Group 2 than in Group 1 (p<0.0001). There were no significant differences between the groups in terms of incision type (p=0.743).
Conclusion: In the presence of co-morbid factors that disrupt wound healing in surgical patients with gastrointestinal malignancy, retention suture can be safely used as a supplement for optimal wound care.
Keywords: Abdominal wound dehiscence, hernia, polydioxanone, wound closure techniques
This study is retrospective; furthermore in that period, all ethics committees across the country has entered a restructuring process. Thus the ethical approval has not been received.
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept - B.B., Y.Ç., R.Y., A.Ö., S.A., E.T., A.Y., G.D.; Design - G.D., B.B., Y.Ç., S.A., E.T.; Supervision - B.B., J.S., R.Y., A.Y., İ.A.Ö.; Funding - R.Y.; Materials - B.B., A.Y.; Data Collection and/or Processing - B.B., İ.A.Ö., R.Y., J.S.; Analysis and/or Interpretation - J.S., B.B., Y.Ç., E.T.; Literature Review - J.S., E.T., G.D., S.A.; Writer - B.B., J.S., İ.A.Ö., R.Y.; Critical Review - R.Y., İ.A.Ö., A.Y.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.