[A new method of aponevrosis suturing after laparotomy in urgent abdominal surgery]. / Sposob ushivaniia aponevroza posle laparotomii v urgentnoi khirurgii.

OBJECTIVE: To improve the results of treatment of patients undergoing laparotomy by using of a new method of aponeurosis suturing after laparotomy. MATERIAL AND METHODS: Training process for a new method of aponeurosis suturing after laparotomy was organized on the patented medical simulator for learning the technique of laparotomy closure. The method was introduced into surgical practice later. The study involved 130 patients who underwent emergency abdominal surgery through median laparotomy. The main group consisted of 70 patients (laparotomy closure using the proposed method (RF patent No.2644846 dated 02/14/18). Interrupted sutures were applied for aponeurosis suturing in the control group. RESULTS: Duration of laparotomy closure was similar in both groups. Postoperative ventral hernias in 1 year after surgery occurred in 5 (8%) patients of the main group and in 11 (18%) patients of the control group. CONCLUSION: The proposed method of aponeurosis suturing after laparotomy is mastered by students and serves as effective method for prevention of postoperative ventral hernias and eventration.

[Preventive abdominal wall repair in high-risk groups of postoperative ventral hernia]. / Preventivnoe éndoprotezirovanie briushnoi stenki v gruppakh riska razvitiia posleoperatsionnykh ventral'nykh gryzh.

AIM: To identify the most important predictors of postoperative hernia and to determine the indications for preventive surgical repair of abdominal wall. MATERIAL AND METHODS: Prospective analysis included 398 medical records of patients who underwent median laparotomy. Experimental tensiometry was applied to determine strength of intact fascia. RESULTS: The main predictors of postoperative hernia are age over 60 years, obesity, upper median laparotomy, connective tissue insufficiency. Combination of factors increases the risk of hernia. The most 'intense' foci of aponeurosis is middle portion of epigastric and initial part of mesogastric areas. You need to consider this features during laparotomy closure. CONCLUSION: Preventive repair may be an effective method for prophylaxis of postoperative hernia after median laparotomy.

[Comparative analysis of laparotomy closure techniques]. / Sravnitel'nyi analiz sposobov ushivaniia laparotomnoi rany.

AIM: To assess experimentally different laparotomy closure techniques. MATERIAL AND METHODS: Experimental research on laboratory animals was performed. Laboratory animals underwent laparotomy followed by aponeurosis suturing by using of interrupted, continuous suture and continuous suture with an arrangement of stitches at different levels. Tensometric and histological examination of tissue specimens together with sutures was made in 7, 14, 60 days after surgery. RESULTS: Correlation of laparotomy closure technique with values of durability, elasticity and wound process course was obtained. CONCLUSION: Continuous suture after laparotomy promotes the formation of more mature granulation tissue and more solid scar with low elasticity compared with interrupted sutures.