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Original research
Prophylactic subcutaneous retention sutures in the prevention of superficial wound separation of midline laparotomy
  1. Elif Iltar1,
  2. Isin Ureyen2,
  3. Tayfun Toptas2,
  4. Selen Doğan3 and
  5. Aysel Uysal1
  1. 1 Department of Gynecology and Obstetrics, Antalya Training and Research Hospital, Antalya, Turkey
  2. 2 Department of Gynecological Oncology, Antalya Training and Research Hospital, Antalya, Turkey
  3. 3 Department of Gynecological Oncology, Akdeniz University, Antalya, Turkey
  1. Correspondence to Dr Elif Iltar, Department of Gynecology and Obstetrics, Antalya Training and Research Hospital, Antalya 07025, Turkey; dktr_elif{at}hotmail.com

Abstract

Objectives This prospective study aimed to determine the effectiveness of prophylactic subcutaneous retention sutures in the prevention of superficial wound separation in women with a confirmed or suspected cancer who had gynecological surgery by midline laparotomy.

Methods This was a non-randomized, controlled intervention study including patients who underwent cancer surgery between May 2018 and August 2019. Patients who underwent midline laparotomy with confirmed or suspected cancer were included and patients who had an early post-operative complication or who underwent surgery again before the removal of stitches were excluded. The independent variables that might predict the superficial wound site dehiscence and prolongation of the hospitalization period were analyzed using logistical regression analysis.

Results A total of 208 patients were included in the study. Age, presence of comorbid diseases, low pre-operative hemoglobin, low pre-operative albumin, higher weight, higher body mass index (BMI), pre- and post-operative blood transfusion, and absence of retention sutures were associated with higher risk of superficial wound separation. Low pre-operative albumin, weight, and BMI were associated with prolonged length of hospital stay. In a multivariate analysis, BMI (OR: 1.12; 95% CI: 1.09 to 1.28, p<0.001) and retention sutures (OR: 0.31; 95% CI: 0.11 to 0.83, p=0.019) retained an independent association with superficial wound separation. In addition, BMI (OR: 1.11; 95% CI: 1.03 to 1.25, p=0.010) and intra-operative complications (OR: 4.10; 95% CI: 1.08 to 15.60, p=0.038) were independent predictors increasing the length of hospital stay, and use of retention sutures (OR: 0.19; 95% CI: 0.05 to 0.66, p=0.009) was an independent predictor decreasing the length of hospital stay.

Conclusions Prophylactic subcutaneous retention sutures reduced superficial wound separation and shortened hospital stay. Prophylactic subcutaneous retention sutures may be considered in patients who undergo gynecological surgery using a midline laparotomy.

  • gynecologic surgical procedures
  • surgical wound infection
  • surgical procedures
  • operative
  • postoperative complications

Data availability statement

All data relevant to the study are included in the article.

https://doi.org/10.1136/ijgc-2021-002446

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    Data availability statement

    All data relevant to the study are included in the article.

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    Footnotes

    • Contributors EI, IU: conceptualization, methodology, supervision, project administration, writing – review and editing. EI, IU: methodology, software, validation, formal analysis, investigation, data curation, writing – original draft. EI: data curation. TT, SD, AU: review and editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.