To study the results of two techniques, simple interrupted closure and continuous with intermittent Aberdeen knot technique for midline laparotomy fascial wound closure. A random selection of 200 midline laparotomy cases was done. In one group (group A) of 100 cases, midline fascial wound closure was done with continuous sutures with intermittent Aberdeen knot technique using Prolene No. 1 suture material. In the other group (group B) of 100 cases, closure was done with the technique of simple interrupted sutures with Prolene No.1 suture material. Comparison of both the techniques regarding preoperative status and postoperative complication such as incisional hernia, wound dehiscence, suture sinus formation, stitch granuloma, and chronic wound pain was done according to clinical examination and recorded in the pro forma prepared. In group A, postoperative complications were incisional hernia 3 %, wound dehiscence 4 %, and suture sinus formation 1 %. In group B, postoperative complication were incisional hernia 5 %, wound dehiscence 4 %, and suture sinus formation 1 %. All these complications were statistically insignificant, in both group comparisons. While the complication such as stitch granuloma 3 %, chronic wound pain 3 %, and wound infection 4 % in group A was significantly less than in group B where the complication of stitch granuloma was 12 %, chronic wound pain 13 %, and wound infection 13 % (P value 0.03, P value 0.018, and P value 0.048, respectively). Both the techniques, simple interrupted suture closure and continuous with intermittent Aberdeen knot closure for midline laparotomy fascial wounds, show a similar rate of postoperative complication such as incisional hernia, wound dehiscence, and suture sinus formation. But the continuous suturing with intermittent Aberdeen knot technique is a better option to prevent complications such as stitch granuloma, chronic wound pain, and wound infection, which are higher in the simple interrupted fascial wound closure technique.

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Study of Two Techniques for Midline Laparotomy Fascial Wound Closure

Despite the advances in surgical technique and materials, abdominal fascial closure had remained a procedure that often reflects a surgeon’s personal preference with reliance on traditional and anecdotal experience. In abdominal surgery, wisely chosen incisions and correct methods of making and closing such wounds are factors of great importance. Any mistake, such as badly placed incision, inept methods of suturing, or ill-judged selection of suture materials, may result in serious complications such as hematoma formation, infection, stitch abscess, an ugly scar, an incisional hernia, or, worst of all, complete disruption of the wound.

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Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

Background There are many options and little guiding evidence when choosing suture types with which to close the abdominal wall fascia. This network meta-analysis investigated the effect of suture ...

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Suture choice to reduce occurrence of surgical site infection, hernia, wound dehiscence and sinus/fistula: a network meta-analysis

Basic surgical skills and anastomoses

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by the formation of amyloid plaques implicated in neuronal death. Genetics, age, and sex are the risk factors attributed to AD. Though omics studies have helped to identify pathways associated with AD, an integrated systems analysis with the available data could help to understand mechanisms, potential biomarkers, and therapeutic targets. Analysis of transcriptomic data sets from the GEO database, and proteomic and metabolomic data sets from literature was performed to identify deregulated pathways and commonality analysis identified overlapping pathways among the data sets. The deregulated pathways included those of neurotransmitter synapses, oxidative stress, inflammation, vitamins, complement, and coagulation pathways. Cell type analysis of GEO data sets showed microglia, endothelial, myeloid, and lymphoid cells are affected. Microglia are associated with inflammation and pruning of synapses with implications for memory and cognition. Analysis of the protein-cofactor network of B2, B6, and pantothenate shows metabolic pathways modulated by these vitamins which overlap with the deregulated pathways from the multi-omics analysis. Overall, the integrated analysis identified the molecular signature associated with AD. Treatment with anti-oxidants, B2, B6, and pantothenate in genetically susceptible individuals in the pre-symptomatic stage might help in better management of the disease. 

/pdf/integrated-multi-omics-analysis-of-alzheimers-disease-shows-1nnwnlnp.pdf

Integrated multi-omics analysis of Alzheimer’s disease shows molecular signatures associated with disease progression and potential therapeutic targets

The objective of this study is to compare Polydioxanone (PDS) and Polypropylene (PPL) suture material for fascial closure,in midline abdominal incisions using interrupted X sutures in terms of post- operative wound complications. Patients for clinical study were selected from the surgical wards of Mc-Gann Teaching and District Hospital, SIMS from Jan 2012 to Dec 2013 with the following inclusion and exclusion criteria: A minimum of 50 cases of randomized midline laparotomy incisions were studied, after informed consent to either a Polydiaxanone (PDS) or Polypropylene (PPL) suture material. Equal number of cases (25) were studied for closure with these two suture materials. The patients were followed-up 01, 02 weeks and then one month after surgery. People around 36-45 years age group formed the maximum numbers in this study. Male to Female ratio was 1.94:1. There was one burst abdomen (out of 25 cases, 4%) in Polypropylene group and none (out of 25 cases) in Polydiaxanone group. Incidence of wound infection was 12%( 6 out of 25 cases) in Polypropylene group compared to 6% ( 3 out of 25 cases) in Polydiaxanone group. The relative risk of wound infection was 0.50. The complications like burst abdomen, wound infection and suture sinus. incidence of suture sinus was 12% (3 out of 25 cases) in Polypropylene group as compared to 4% (1 out of 25 cases) in Polydiaxanone group. Infection rate was 12% (6 cases) in Polypropylene group and 6% (3 cases) in Polydiaxanone group. Hence interrupted X suture technique using No.l Polydiaxanone (PDS) for closure of midline laparotomy incision, is superior to no. 1 Polypropylene (PPL) suture material. Also PDS is superior in preventing major post-operative wound.

Comparison Between Delayed-Absorbable Polydioxanone (PDS) And Non-Absorbable (POLYPROPELENE) Suture Material In Abdominal Wound Closure

Integrated network pharmacology approach shows a potential role of Ginseng catechins and ginsenosides in modulating protein aggregation in Amyotrophic Lateral Sclerosis

V Darshan

Papers

Comparison Between Delayed-Absorbable Polydioxanone (PDS) And Non-Absorbable (POLYPROPELENE) Suture Material In Abdominal Wound Closure

Integrated network pharmacology approach shows a potential role of Ginseng catechins and ginsenosides in modulating protein aggregation in Amyotrophic Lateral Sclerosis