A randomized comparison of continuous versus interrupted mass closure of midline incisions in patients with gynecologic cancer

Mario Colombo, Angelo Maggioni, Gabriella Parma, Salvatore Scalambrino, Rodolfo Milani

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To address the incidence of deep wound dehiscence and incisional hernia formation with two types of mass closure after vertical midline laparotomy performed in patients with gynecologic cancer. Methods: Continuous and interrupted mass closures were compared randomly in 632 patients. Both methods were performed with absorbable material. Of the 614 subjects who could be evaluated, 308 underwent a continuous, nonlocking closure with looped polyglyconate suture, and 306 were closed with interrupted polyglycolic acid according to the Smead-Jones technique. Results: Three (1%) subjects with the continuous closure and five (1.6%) with the interrupted closure had an abdominal wound infection (P = .50). One patient whose incision was closed with continuous suturing had a deep wound dehiscence (without evisceration). The follow-up period was 6 months to 3 years. No patient had evidence of chronic sinus drainage. Thirty-two (10.4%) of the patients who had the continuous closure and 45 (14.7%) of those who were closed with the interrupted method had evidence of incisional hernia (P = .14). No hernia developed in any patient with a wound infection. Four (1.3%) hernias after the continuous closure and eight (2.6%) after the interrupted closure required surgical repair because of patient discomfort (P = .38). Conclusion: The interrupted closure was not superior to the continuous closure for short- and long-term wound security. The continuous method was preferable because it was more cost-efficient and faster.

Original languageEnglish
Pages (from-to)684-689
Number of pages6
JournalObstetrics and Gynecology
Volume89
Issue number5 I
DOIs
Publication statusPublished - May 1997

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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