Complications - Abdominal wall closure – techniques: Loop suture and small tissue bites

  1. Postoperative complications and their prevention

    • Wound infection with secondary fascial dehiscence → single shot antibiotic therapy; preventing necrosis formation from excessive tightening of the suture with subsequent tissue strangulation
    • Acute wound dehiscence (burst abdomen) → adequate tension of the running suture with low strain on the tissue bridges to avoid "button holing"; atraumatic technique; prevention of wound infection see above; suture-to-wound length ratio of at least 4:1
    • Chronic wound and fascial dehiscence with formation of incisional hernia→ atraumatic technique, prevention of wound infections see above; avoidance of high suture tension with tissue destruction by the suture cutting through tissue; suture-to-wound length ratio of at least 4:1; avoid excessively loose suture with subsequent leakage.
    • Hematomas/seromas → thorough hemostasis; subcutaneous suture if applicable, Redon drain
    • Suture fistulas/granulomas → avoidance of non-absorbable suture material
    • Chronic wound pain → avoidance of non-absorbable suture material