Effect of retension sutures on abdominal pressure after abdominal surgery

Abstract

Purpose: To evaluate the effect of retention sutures on abdominal pressure and postoperative prognosis in abdominal surgery patients.

Methods: This prospective cohort study included patients who were admitted to Daping Hospital from May 15, 2014 to October 11, 2014. A total of 57 patients were enrolled, including 18 patients in the "U" type retention suture group, 17 patients in the intermittent retention suture group, and 22 patients in non-retention suture group. The demographic data, clinical data and risk factors for abdominal wound dehiscence were recorded. The bladder pressure (IVP) was monitored preoperatively, intraoperatively, and four days postoperatively. Additionally, the incidence of abdominal wound dehiscence and infection 14 days after the operation was recorded.

Results: During the operation, the IVP decreased and then increased; it was at its lowest 1 h after the start of the operation (5.3 mmHg ± 3.2 mmHg) and peaked after tension-reducing (8.8 mmHg ± 4.0 mmHg). The IVP values in the "U" type retention suture group and intermittent retention suture group were higher than in the non-retention suture group 4 days after operation (p < 0.005). The Visual Analogue Scale (VAS) pain scores were 3.9 ± 2.2, 3.8 ± 2.0, and 3.0 ± 1.0 in the retention suture group, intermittent retention suture group and non-retention suture group, respectively. The VAS pain scores in the "U" type tension-reducing group and intermittent tension-reducing group were higher than in the non-tension-reducing group (p < 0.005).

Conclusion: Although retention sutures may reduce the incidence of postoperative wound dehiscence in abdominal surgery patients, they can increase the IVP and postoperative pain.

Keywords: Abdominal compartment syndrome; Infection; Intra-abdominal hypertension; Intra-abdominal pressure; Surgical wound dehiscence; Sutures.

Fig. 1

The intermittent retention suture group.

Fig. 2

The “U” type retention suture group.

Fig. 3

Changes in IVP at various time points during the operation. * represents preoperative IVP > IVP after anesthesia, p < 0.005; # represents IVP after cutting of the rectus abdominis sheath < IVP after cutting of the rectus abdominis guard, p < 0.005; ˆ represents IVP at 1 h after beginning operation < IVP after closure of the rectus abdominis guard, IVP after closure of the rectus abdominis sheath < IVP after closure of the subcutaneous tissue, p < 0.005; & represents IVP after closure of the skin < IVP after retention-reducing, p < 0.005.

Fig. 4

Changes in IVP during the perioperative period. * represents IVP on the first day after the operation, the “U” type retention suture and intermittent retention suture groups > non-retention suture group, p < 0.005; the IVP on the second day after the operation, the “U” type retention suture and intermittent retention suture groups > non-retention suture group, p < 0.005; the IVP on the third day after the operation, the “U” type retention suture and intermittent retention suture groups > non-retention suture group, p < 0.005; the IVP on the fourth day after the operation, the “U” type retention suture and intermittent retention suture groups > non-retention suture group, p < 0.005.