Laparorrhaphy with Reinforced Tension Line in Patients Undergoing Emergency Midline Laparotomy
Keywords:
midline laparotomy; aponeurosis; eviscerationAbstract
Introduction: Evisceration is a serious postoperative complication and a cause of reoperation in patients undergoing emergency midline laparotomy.
Objective: To characterize patients undergoing emergency midline laparotomy and laparorrhaphy with a tension-reinforced suture line.
Methods: A prospective, descriptive, and longitudinal study was conducted with patients who underwent surgical treatment via emergency midline laparotomy and laparorrhaphy with a reinforced tension line in the general surgery department of the Leopoldito Martínez General Teaching Hospital during the period from September 2022 to March 2024.
Results: The age group most prevalent in the study sample was 30–50 years (41 patients/53.94%), followed by 19–29 years (35 patients/46.05%), while females accounted for 76.31%. The most common associated condition was hypertension (51.31%), and the most common local postoperative complication was surgical site infection (52.38%). Among the risk factors, protein-energy malnutrition stood out (17.10%), and there were no patients with evisceration.
Conclusions: Closure of the aponeurosis using the reinforced tension line method proved effective as a prophylaxis against evisceration in patients who underwent emergency exploratory midline laparotomy.
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1. Barrios Viera O, González Machín M. Comparación de dos métodos de cierre aponeurótico en pacientes con laparotomía media. MEDISUR. 2024 [acceso 06/02/2026];22(5) Disponible en: https://medisur.sld.cu/index.php/medisur/issue/ view/151
2. Pereira JA, López M. El cierre de laparotomía media basado en la evidencia y la evidencia de su uso. Cir Esp. 2021 [acceso 06/02/2026];100(1):1-2. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-sumario-vol-100-num-1-S0009 739X21X00103
3. Barrios O, González M. Caracterización de pacientes con laparotomía media y cierre aponeurótico con línea de tensión reforzada. Rev Cubana Cir. 2024 [acceso 06/02/2026];63:e1602. Disponible en: http://scielo.sld.cu/scielo.php?script=sci _arttext&pid=S0034-74932024000100007&lng=es
4. Hollinsky C, Sandberg S, Kocijan R. Preliminary results with their enforced tension line: A new technique for patients with ventral abdominal wall hernias. Am J Surg. 2007;194: 234-9. DOI: http://dx.doi.org/10.1016/j.amjsurg.2006.09.045
5. Sharma G, Prashar N, Gandotra N. Comparison of suture technique (interrupted vs.
continuous) with respect to wound dehiscence. Indian J Med Sci 2020;72(3):191-4. DOI: https://doi.org/10.25259/IJMS_21_2020
6. Benet O, Yepes AF, Casimiro JA, Ortiz D, Afonso N, Marchena J. Riesgo de evisceración en función del tiempo postoperatorio transcurrido. Cir Esp. 2020 [acceso 06/02/2026];98(Espec Congr 1):884. Disponible en: www.elsevier.es/cirugia
7. Herber L, Rasslan R, Novo FCF, Lima TMA, Damous SHB, Bernini CO, et al. Prevention of Fascial Dehiscence with Onlay Prophylactic Mesh in Emergency Laparotomy: A Randomized Clinical Trial. J Am Coll Surg. 2020;230(1):76-87. Disponible en: DOI: https://doi.org/10.1016/j.jamcollsurg.2019.09.010
8. Díaz R, Ortiz C, Marinkovic B, Jerez O, D’Aguzan N, Turu M. Consenso para la apertura y cierre de laparotomía media suprainfraumbilical utilizando metodología Delphi. Rev. Cirugía. 2019 [acceso 06/02/2026];71(4):122-8. Disponible en: https://www.revistacirugia.cl/index.php/revistacirugia/article/view/324
9. Urgellés S, Álvarez M, Reyes E, Duménigo CA, Fleites YA. Factores de riesgo asociados a las complicaciones postquirúrgicas de la histerectomía abdominal. Revista Cubana de Obstetricia y Ginecología. 2021 [acceso 06/02/2026];47(1):e690. Disponible en: https://www.medigraphic.com/pdfs/revcubobsgin/cog-2021/cog2 11f.pdf
10. Zolin SJ, Rosen MJ. Failure of Abdominal Wall Closure: Prevention and Management. Surgical Clinics of North America. 2021;101(5):875-88. DOI: https://doi.org/10.1016/j.suc.2021.07.001
11. Kunju RD. A clinical study of continuous and interrupted fascial closure in emergency midline laparotomy at a tertiary care centre. Int Surg J. 2017 [acceso 06/02/2026];4(6):2014-7. Disponible en: http://www.ijsurgery.com
12. Wenzelberg CL, Rogmark P, Ekberg A, Petersson U. Reinforced tension-line suture after laparotomy: early results of the Rein4CeTo1 randomized clinical trial. BJS. 2024;111(10):1-7. DOI: https://doi.org/10.1093/bjs/znae265
13. Henriksen N, Deerenberg E, Venclauskas L. Meta-analysis on Materials and Techniques for Laparotomy Closure: The MATCH Review. World J Surg. 2018;42:1666-78. DOI: https://doi.org/10.1007/s00268-017-4393-9
14. El Charif MH, Hassan Z, Hoballah J, Khalife M, Sbaity E. Protocol for a randomized controlled trial comparing wound Complications in elective midline laparotomies after FAscia Closure using two different Techniques of Running sutures: COFACTOR trial. 2020;21(1):608. DOI: https://doi.org//10.1186/s13063-020-04507-8
15. Bloemen A, De Kleijn RCMF, Van Steensel S, Aarts F, Schreinemacher MHF, Bouvy ND. Laparotomy closure techniques: ¿Do surgeons follow the latest guidelines? Results of a questionnaire. Int J Surg. 2019;71:110-6. DOI: https://doi.org//10.1016/j.ijsu.2019.09.024
16. Jairam AP, López M, Garcia JM, Pereira JA, Timmermans L, Jeekel J et al. Prevention of incisional hernia after midline laparotomy with prophylactic mesh reinforcement: a meta-analysis and trial sequential analysis. BJS Open. 2020;4:357-68. DOI: https://doi.org//10.1002/bjs5.50261
17. Tansawet A, Numthavaj P, Techapongsatorn S, Wilasrusmee C, Attia J, Thakkinstian A. Mesh position for hernia prophylaxis after midline laparotomy: a systematic review and network meta-analysis of randomized clinical trials. Int J Surg. 2020;83:144-51. DOI: https://doi.org//10.1016/j.ijsu.2020.08.059
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