| Abstract [eng] |
Background. Postoperative wound complications are a burden for patients and health care system. Optimal abdominal wall closure technique might be one of the key points, trying to reduce morbidity of these complications. The aim of this systematic review and survey was to evaluate abdominal wall closure techniques used for midline laparotomies. Methods. A systematic literature search using PubMed was conducted until 2022-04-25. Self-administered questioner of surgeons about closure techniques was also performed in three stages from 2021-09 until 2022-02. Results. A total of 19 randomized controlled trials were included in the systematic review. All investigated closure techniques (small bites, reinforced tension line and prophylactic mesh) in all publications evaluating incisional hernia formation, showed statistically significantly lower rate of incisional hernia when compared with a standard suture. Results of other wound complications varied between the studies, without a general negative trend. Survey showed that half of the surgeons working in hospitals other than Vilnius university hospital Santaros clinics had no knowledge of small bites technique. Conclusions. Small bites technique and prophylactic mesh can be used to lower the incidence of incisional hernia without significant negative effects. Theoretical and practical training in hospitals is needed to encourage surgeons to use the small bites more frequently. |
