J Minim Invasive Surg.  2018 Dec;21(4):160-167. 10.7602/jmis.2018.21.4.160.

The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

• Kim DH
• Park JH
• Joo JI
• Jeon JY
• Lim SW

• KMID: 2429389
• DOI: http://doi.org/10.7602/jmis.2018.21.4.160

Abstract

PURPOSE
The aim of our study was to present an abdominal wall closure technique using barbed suture V-Locâ„¢ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA.
METHODS
From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture V-Locâ„¢ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc.
RESULTS
The V-Loc closure group showed shorter total operation time (40.0±15.4 min vs. 44.9±16.3 min, p=0.013) and abdominal wall closure time (5.5±0.9 min vs. 6.5±0.8 min, p < 0.001). Postoperative incision length was significantly shorter in the V-Loc closure group (1.1±0.3 cm vs. 1.8±0.4 cm, p < 0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups.
CONCLUSION
In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

Keyword

Laparoscopy; Appendectomy; Suture technique

MeSH Terms

Abdominal Wall*
Appendectomy*
Case-Control Studies
Diet
Fascia
Humans
Laparoscopy
Length of Stay
Methods*
Patient Satisfaction
Retrospective Studies
Running*
Skin
Surgical Wound Infection
Suture Techniques
Sutures*
Wounds and Injuries