Evidence map›Paper›PMID 34448934›Full record

ArticleSurgical endoscopy2022

Examination of abdominal wall perfusion using varying suture techniques for midline abdominal laparotomy closure.

Bradley S Kushner, Saeed Arefanian, Jared McAllister, Wen Hui Tan, Matthew Grant, Robert MacGregor, Arnab Majumder, Jeffrey A Blatnik

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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Bradley S KushnerDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA. b.kushner@wustl.edu.ORCID http://orcid.org/0000-0002-7360-7642
Saeed ArefanianDepartment of Surgery, University of Missouri, Columbia, MO, 65211, USA.
Jared McAllisterDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Wen Hui TanDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Matthew GrantDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Robert MacGregorDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Arnab MajumderDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Jeffrey A BlatnikDepartment of Surgery, Washington University, Saint Louis, Saint Louis, MO, 63110, USA.
Washington University in St. Louis · USSaint Louis University · ESUniversity of Missouri · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith a growing interest in the primary prevention of incisional hernias, it has been hypothesized that different suturing techniques may cause various levels of tissue ischemia. Using ICG laser-induced fluorescence angiography (ICG-FA), we studied the effect of different suture materials and closure techniques on abdominal wall perfusion.

methodsFifteen porcine subjects underwent midline laparotomy, bilateral skin flap creation, and three separate 7 cm midline fascial incisions. Animals underwent fascial closure with 5 different techniques: (1) Running 0-PDS® II (polydioxanone) Suture with large bites; (2) Running 0-PDS II Suture with small bites; (3) Interrupted figure-of-eight (8) PDS II Suture, (4) Running 0-barbed STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device large bite; (5) Running 0-STRATAFIX Symmetric PDS Plus Device small bites. ICG-FA signal intensity was recorded prior to fascial incision (baseline), immediately following fascial closure (closure), and at one-week (1-week.). Post-mortem, the abdominal walls were analyzed for inflammation, neovascularity, and necrosis.

resultsPDS II Suture with small bites, fascial closure at the caudal 1/3 of the abdominal wall, and the 1-week time period were all independently associated with increased tissue perfusion. There was also a significant increase in tissue perfusion from closure to 1-week when using small bites PDS II Suture compared to PDS II Suture figure-of-8 (p < 0.001) and a trend towards significance when compared with large bites PDS II Suture (p = 0.056). Additionally, the change in perfusion from baseline to 1 week with small bites was higher than with figure of 8 (p = 0.002). Across all locations, small bite PDS II Suture has greater total inflammation than figure of 8 (p < 0.001).

conclusionsThe results suggest that the small bite technique increases abdominal wall perfusion and ICG-FA technology can reliably map abdominal wall perfusion. This finding may help explain the reduced incisional hernia rates seen in clinical studies with the small bite closure technique.

Indexed as

Abdominal WallAbdominal Wound Closure TechniquesIncisional HerniaAnimalsHumansInflammationLaparotomyPerfusionPolydioxanoneSuturesSuture TechniquesSwinePolydioxanoneAbdominal wall closure techniqueAbdominal wall perfusionIncisional hernia repairIndocyanine greenVentral hernia repair

Identifiers

PMID34448934
OpenAlexW3194451568

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.