A Prospective Study of a Cost-Effective Method for Prevention of Incisional Hernia in Subcostal and Lumbar Incisions by Use of Nylon Loop, Intermittent Mass Closure
Journal Title: New Indian Journal of Surgery - Year 2018, Vol 9, Issue 6
Abstract
Background and Objective: Occurrence of incisional hernia in subcostal incisions (used mainly for open cholecystectomy and liver surgery) and lumbar incisions (used mainly for nephrectomy and pyelolithotomy) is relatively less travelled journey than midline incisional hernias. During my tenure here as an assistant professor, in 2 years, I saw many cases of weakness (flank bulge) due to damage to subcostal nerve, to pure hernias. All of us were using layered closure using vicryl 1 no. for these incisions as a standard method. post-operative infection was rare in these clean cases. I thought that layered closure must be the cause and mass closure could prevent this complication. Methodology: We decided to do a prospective study to know the fact. During next 5 years 50 patients were operated for different indications through these incisions, 20 through lumbar and 30 through subcostal incisions. All the incisions were closed by nylon 1 no. mass closure as described below. Patients were followed up in O.P.D. and by telephone. The results were noted. Results: No patient with mass closure technique developed weakness with mass closure during follow up. Conclusion: Mass closure, with non-absorbable suture, of subcostal and lumbar incisions as described below is a better method of closure than layered closure using delayed absorbable suture for prevention of post-operative hernias.
Authors and Affiliations
Shah Bhavin K.
Keywords
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- EP ID EP548237
- DOI 10.21088/nijs.0976.4747.9618.3
- Views 91
- Downloads 0
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