Start your free 3-day trial — no credit card required, full access included

Login Register

Complications - Abdominal wall closure - Techniques: loop suture and "small tissue bites"

general and visceral surgery
Activate now
Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Postoperative Complications and Their Prevention

    • Wound infection with secondary fascial dehiscence → single shot antibiotic; prevention of necrosis formation by avoiding excessive tightening of the suture causing tissue strangulation
    • Acute wound rupture (burst abdomen) → adequate tension of the continuous suture with minimal stress on tissue bridges to avoid "button holes"; atraumatic technique; prevention of wound infections as above; suture-to-wound length ratio of at least 4:1
    • Chronic wound rupture with fascial dehiscence and formation of a scar hernia → atraumatic technique, prevention of wound infections as above; avoidance of high suture tensions with tissue destruction due to suture cutting through; suture-to-wound length ratio of at least 4:1; avoid too loose sutures with leakage
    • Hematomas/Seromas → careful hemostasis; if necessary, subcutaneous suture, Redon drainage
    • Suture fistulas/granulomas → avoidance of non-absorbable suture material
    • Chronic wound pain → avoidance of non-absorbable suture material
to top