Skin closure at laparoscopy

Abstract

Study objective: To discern the best method of wound closure after laparoscopy based on patient acceptability of pain, complications, and cosmetic result.

Design: Randomized, prospective study.

Setting: A university-affiliated hospital.

Patients: Fifty-four women. Interventions. The women received interrupted 3-0 nylon sutures, subcuticular 3-0 polyglactin 910 sutures, or adhesive strips for skin closure. At the umbilical port site the rectus sheath was closed with a single 0 polyglactin suture and then one of the three materials for skin closure. The lateral ports were closed with a combination of these materials, allowing each patient to act as her own control.

Measurements and main results: Pain was significantly less in wounds closed by subcuticular technique than in those closed by either transcutaneous suture or adhesive strips. This was seen for the 5-mm, 10-mm, and umbilical port sites. There was no statistically significant difference in the rate of reported complications or patient satisfaction between subcuticular and transcutaneous wound sites.

Conclusion: We believe these results support subcuticular methods of wound closure after laparoscopic procedures.