The Effect of Using a Delayed-Absorbable Subdermal Skin Closure on Postoperative Wound Complications in Obese Women Undergoing Abdominal Gynecologic Surgery [46]

Abstract

Wound complications in obese patients can use considerable resources in their care. Although closure of the subcutaneous layers has shown to help, these problems still occur. We hypothesized that the addition of subdermal closure using a delayed-absorbable suture to standard wound-closure techniques in obese patients might further reduce wound problems.

A chart review of laparotomies with midline vertical skin incision performed for gynecologic disorders during the previous 3 years was conducted. In addition to demographic data, data on wound separation, use of antibiotics, readmission for wound care, referral to the wound care center, and use of wound vacuum dressings were abstracted. Separate χ2 or Fisher exact tests were used as appropriate.

We identified 106 patients; 36 received standard closure plus subdermal closure using a delayed-absorbable suture (case group) and 70 received standard closure (control group). Body mass index (calculated as weight (kg)/[height (m)]2), age, and comorbidities were similar among the groups. Wound separation was noted in 10 patients (four in the case group, six in the control group). Antibiotics were used in one patient (in the control group). Three patients were referred to the wound care center (one in the case group, two in the control group) and three patients were readmitted to the hospital for wound care (all from the control group). Wound vacuum dressings were used in two patients (both in the control group). No difference in postoperative visits was noted between groups.

A tendency toward fewer wound complications was seen in the group receiving subdermal closure using a delayed-absorbable suture. Owing to the rarity of these complications and the exploratory nature of our study, no statistical significance was noted for the variables studied between groups. A larger prospective clinical trial is needed.