The advantage of transverse laparotomy closed with continuous absorbable single-layer stitch

Abstract

The authors emphasize the advantage of transverse incisions because they provide the surgeon not only with excellent bilateral view of the operated area, but what is most important, they have significantly least negative effect on respiratory functions and the composition of blood gases, which are of major importance in patients with chronic respiratory failure. Due to the much smaller retraction forces, the incidence of postoperative dehiscences and hernias is smaller. It is an incision which interferes the least with the innervation of the abdominal wall and thus is not only less painful, but has also better healing parameters, offers excellent access to pathology from oesophagus up to sigmoid. It is an ideal incision for left open abdomen due to much less retraction of the abdominal wall and described closure is safe, simple, cheap, fast and reliable in risk, obese patients with impaired healing. The closure by a continuous, absorbable, looped double suture is not only simple, but what is most important, it is reliable and associated with minimal postoperative complications. The mean time of closure 13.6 min., supuration after 10th post-op day in 2%, none burst abdomen, 4 incisional hernias (0.8%), these are significantly better results than compared to longitudinal incisions. Authors in details describe the running Smead Jones closure technique.