Prediction and prevention of fascial dehiscence after laparotomy

Samartsev V.A.; Gavrilov V.A.; Kuznetsova M.P.; Pushkarev B.S.; Domrachev A.A.

doi:https://doi.org/10.17116/hirurgia202501147

Samartsev V.A.

Wagner Perm State Medical University

ORCID: 0000-0001-6171-9885

Gavrilov V.A.

Vagner Perm State Medical University

ORCID: 0000-0002-1950-065X

Kuznetsova M.P.

Wagner Perm State Medical University

ORCID: 0000-0001-8403-4926

Pushkarev B.S.

Wagner Perm State Medical University

ORCID: 0000-0001-5046-6130

Domrachev A.A.

Wagner Perm State Medical University

Prediction and prevention of fascial dehiscence after laparotomy

Authors:

Samartsev V.A., Gavrilov V.A., Kuznetsova M.P., Pushkarev B.S., Domrachev A.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(1): 47‑53

DOI: 10.17116/hirurgia202501147

Read: 987 times

Contact the author

Table of contents

To cite this article:

Samartsev VA, Gavrilov VA, Kuznetsova MP, Pushkarev BS, Domrachev AA. Prediction and prevention of fascial dehiscence after laparotomy. Pirogov Russian Journal of Surgery. 2025;(1):47‑53. (In Russ.)
https://doi.org/10.17116/hirurgia202501147

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Abstract:

OBJECTIVE

To evaluate the efficacy of fascial dehiscence prevention suture in patients with perioperative risk factors regarding the incidence of this complication after laparotomies in abdominal surgery.

MATERIAL AND METHODS

A retrospective-prospective controlled randomized study included 112 patients with abdominal surgical diseases who underwent surgery between 2013 and 2023. Patients were divided into three groups. In the first group (n=57), fascial dehiscence occurred in early postoperative period. The second group (n=41) retrospectively included random patients without fascial dehiscence in postoperative period. In the third group (n=22), original preventive suturing of laparotomy was applied. The validity of differences in continuous variables was assessed using the Kruskal—Wallis test. Categorical variables were analyzed using chi-square test, as well as Dunn’s and Fisher’s post-hoc tests. Differences were significant at p<0.05. The third group did not statistically differ from the first one.

RESULTS

A comprehensive perioperative assessment of risk factors and original aponeurosis suturing technique prevented fascial dehiscence.

Keywords:

fascial dehiscence

perioperative risk factors

prevention of fascial dehiscence

aponeurosis suture

prevention of complication

Authors:

Samartsev V.A.

Wagner Perm State Medical University

ORCID: 0000-0001-6171-9885

Gavrilov V.A.

Vagner Perm State Medical University

ORCID: 0000-0002-1950-065X

Kuznetsova M.P.

Wagner Perm State Medical University

ORCID: 0000-0001-8403-4926

Pushkarev B.S.

Wagner Perm State Medical University

ORCID: 0000-0001-5046-6130

Domrachev A.A.

Wagner Perm State Medical University

Received:

22.03.2024

Accepted:

04.04.2024

Close metadata

References:

Samartsev VA, Gavrilov VA, Kuznetsova MV, Kuznetsova MP. Risk factors of abdominal wound dehiscence in abdominal surgery. Pirogov Russian Journal of Surgery. 2020;(10):68-72. (In Russ.). https://doi.org/10.17116/hirurgia202010168
Samartsev V, Kuchumov A, Gavrilov V. Sutures in abdominal surgery: Biomechanical study and clinical application. Open Medicine. 2014;9(6):849-859.
Grigoriev SG. Treatment and prevention of eventrations. Surgery. 1991;5:117-120. (In Russ.).
Lazarenko VA, Ivanov SV, Ivanov IS, Ivanov AV, Tsukanov AV, Tarabrin DV, Kulabukhov AS, Tarabrina OV. Comparative analysis of the effect of vitamin C and potassium orotate on the morphological picture during the implantation of a hernia mesh in an experiment. Kursk Scientific and Practical Bulletin «Man and His Health». 2019;(1):33-40. (In Russ.). https://doi.org/10.21626/vestnik/2019-1/04
Couch D, Mann C, Miller A. PTU-228 Abdominal fascial wound closure with 2—0 sutures does not lead to increased rates of dehiscence or incisional hernia. Gut. 2015;64:163-163.
López-Cano M, García-Alamino JM, Antoniou SA, Bennet D, Dietz UA, Ferreira F, Fortelny RH, Hernandez-Granados P, Miserez M, Montgomery A, Morales-Conde S, Muysoms F, Pereira JA, Schwab R, Slater N, Vanlander A, Van Ramshorst GH, Berrevoet F. EHS clinical guidelines on the management of the abdominal wall in the context of the open or burst abdomen. Hernia. 2018;22(6):921-939. https://doi.org/10.1007/s10029-018-1818-9
Malbrain MLNG. Abdominal pressure in the critically ill. Current Opinion in Critical Care. 2000;6(1):17-29.
Mukakala AK, Mutombo D, Iteke R, Yumba S, Kasanga T, Mukangala S, Wakunga UE, Ugumba C, Kalau W. Early post-operative complications in abdominal surgery at the university clinics of Lubumbashi: Frequency, diagnosis and prognosis. International Journal of Surgery Science. 2021;5:136-142. https://doi.org/10.33545/surgery.2021.V5.i1c.601
Patchana T, Savla P, Brazdzionis J, Wiginton J 4th, Takayanagi A, Zampella B, Schiraldi M, King C. A Novel Method for Practicing Fascial Closure with Suture. Cureus. 2020;12(4):e7803. https://doi.org/10.7759/cureus.7803
Pettersson P, Petersson U. O32 Treatment of fascial dehiscence is improved by MESH reinforcement. British Journal of Surgery. 2021;108(8). https://doi.org/10.1093/bjs/znab396.031
Pickhardt PJ, Shimony JS, Heiken JP, Buchman TG, Fisher AJ. The abdominal compartment syndrome: CT findings. American Journal of Roentgenology. 1999;173(3):575-579. https://doi.org/10.2214/ajr.173.3.10470882
Zucker BE, Simillis C, Tekkis P, Kontovounisios C. Suture choice to reduce occurrence of surgical site infection, hernia, wound dehiscence and sinus/fistula: a network meta-analysis. Annals of the Royal College of Surgeons of England. 2019;101(3):150-161. https://doi.org/10.1308/rcsann.2018.0170