Single- vs multiple-layer wound closure for flank incisions

• Verfasst von: Kriegmair, Maximilian [VerfasserIn]
• Verfasst von: Younsi, Nina [VerfasserIn]
• Verfasst von: Hiller, Kiriaki [VerfasserIn]
• Verfasst von: Leitsmann, Conrad [VerfasserIn]
• Verfasst von: Kowalewski, Karl-Friedrich [VerfasserIn]
• Verfasst von: Siegel, Fabian [VerfasserIn]
• Verfasst von: Rothamel, Martin [VerfasserIn]
• Verfasst von: Ritter, Manuel [VerfasserIn]
• Verfasst von: Bolenz, Christian [VerfasserIn]
• Verfasst von: Kriegmair, Martin [VerfasserIn]
• Verfasst von: Trojan, Lutz [VerfasserIn]
• Verfasst von: Michel, Maurice Stephan [VerfasserIn]
• Titel: Single- vs multiple-layer wound closure for flank incisions
• Titelzusatz: results of a prospective, randomised, double-blinded multicentre study
• Verf.angabe: Maximilian C. Kriegmair, Nina Younsi, Kiriaki Hiller, Conrad Leitsmann, Karl F. Kowalewski, Fabian Siegel, Martin Rothamel, Manuel Ritter, Christian Bolenz, Martin Kriegmair, Lutz Trojan and Maurice S. Michel
• Jahr: 2021
• Umfang: 7 S.
• Fussnoten: First published: 21 June 2020 ; Gesehen am 18.05.2021
• Titel Quelle: Enthalten in: BJU international
• Ort Quelle: Oxford : Wiley-Blackwell, 1999
• Jahr Quelle: 2021
• Band/Heft Quelle: 127(2021), 1, Seite 64-70
• ISSN Quelle: 1464-410X
• DOI: doi:10.1111/bju.15148
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: #uroonc
• Sach-SW: flank bulge
• Sach-SW: flank incision
• Sach-SW: nephrectomy
• Sach-SW: partial nephrectomy
• Sach-SW: retroperitoneal surgery
• K10plus-PPN: 1758040270
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Objective To compare the incidence of postoperative flank bulges between patients with multiple-layer closure and single superficial-layer closure after retroperitoneal surgery via open flank incision in the SIngle versus MUltiple-LAyer wound Closure for flank incision (SIMULAC) trial. Patients and Methods The study was a randomised controlled, patient- and assessor-blinded, multicentre trial. Between May 2015 and February 2017, 225 patients undergoing flank incisions were randomised 1:1 to a multiple-layer closure (SIMULAC-I) or a single superficial-layer closure (SIMULAC-II) group. The primary outcome was the occurrence of a flank bulge 6 months after surgery. Results Overall, 177 patients (90 in SIMULAC-I, 87 in SIMULAC-II) were eligible for final assessment. The cumulative incidence of a flank bulge was significantly higher in the SIMULAC-II group (51.7%) compared to the SIMULAC-I group [34.4%; odds ratio (OR) 2.04, 95% confidence interval (CI) 1.11-3.73; P = 0.02]. Rate of severe postoperative complications (4.4% SIMULAC-I vs 10.3% SIMULAC-II; P = 0.21) or hernia (6.7% SIMULAC-I vs 10.3% SIMULAC-II; P = 0.59) was similar between the groups. There was no difference in pain (visual analogue scale) and the requirement for pain medication at 6 months postoperatively. Quality of life assessed with the European Quality of Life 5 Dimensions Questionnaire was higher in the SIMULAC-I group compared to the SIMULAC-II group at 6 months postoperatively, with a (median range) score of 80 (30-100) vs 75 (5-100) (P = 0.012). Conclusion The overall risk of a flank bulge after flank incision is high. Multiple-layer closure after flank incision should be performed as a standard procedure.