Interrupted or continuous slowly absorbable sutures - design of a multi-centre randomised trial to evaluate abdominal closure techniques INSECT-trial [ISRCTN24023541]

Hanns-Peter Knaebel, Moritz Koch, Stefan Sauerland, Markus K Diener, Markus W Büchler, Christoph M Seiler, INSECT Study Group of the Study Centre of the German Surgical Society, Hanns-Peter Knaebel, Moritz Koch, Stefan Sauerland, Markus K Diener, Markus W Büchler, Christoph M Seiler, INSECT Study Group of the Study Centre of the German Surgical Society

Abstract

Background: The closure of the abdomen after median laparotomy is still a matter of debate among surgeons. Further well designed and performed randomised controlled trials determining the optimal method of abdominal fascial closure are needed.

Design: This is a three armed, multi-centre, intra-operatively randomised, controlled, patient blinded trial. Over 20 surgical departments will enrol 600 patients who are planned for an elective primary abdominal operation. The objective of this study is to compare the frequency of abdominal incisional hernias between two continuous suture techniques with different, slowly absorbable monofilament materials and an interrupted suture using an absorbable braided suture material at one year postoperatively.

Conclusion: This trial will answer the question whether the continuous abdominal wall closure with a slowly absorbable material with longitudinal elasticity is superior to the continuous suture with a material lacking elasticity and to interrupted sutures with braided thread.

Figures

Figure 1
Figure 1
Principles of continuous abdominal wall closure. A Anchorage of the suture cranially/caudally outside the incision B Intersection of the loops in the middle of the incision C Knotting of each loop Images reprinted with courtesy of Mrs. B. Wiehn, BBD Aesculap, Tuttlingen Germany
Figure 2
Figure 2
INSECT-Trial according to CONSORT (Moher et al. Lancet 2001)

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Source: PubMed

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