Closures General

■ the length of the suture material should be 4:1 to the length of the wound

■ avoid excessive tension on the suture closure of the fascial edgestraction as it may compromise vascularization of the wound edges

■ below the umbilicus, the posterior fascia (rostral to the smi-circular line caudal to which there is no posterior rectus fascia) and then the anterior fascia of the rectus abdominis muscle can bei closed as separate layers

■ Grasp the needle with the tip of the instrument

Midline Laparotomy

■ The fascia is closed with a running loop of monofilament, absorbable suture material (e.g., PDS II-1 loop or Maxon-1 loop) with or without inclusion of the peritoneum

■ The subcutaneous fatty layer is not closed and subcutaneous drains are rarely needed

■ The skin is preferably closed with a running intracutaneous absorbable monofilament suture (e.g.,Maxon 5-0) or with staples

Subcostal Incision

■ In contrast to the midline laparotomy, the fascia should be closed in two layers Trocar Wound Closure

■ Ports are removed under direct vision with the camera and port sites should be routinely watched for 10 s to exclude port site bleeding

■ All fascial defects of trocars greater than 5 mm are closed with absorbable sutures (e.g.,Vicryl 0)

■ The skin is closed with interrupted mattress sutures (e.g., Dermalon 4-0) or with staples

Was this article helpful?

0 0
How to Stay Young

How to Stay Young

For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.

Get My Free Ebook

Post a comment