EXPERIMENTAL STUDY OF METHOD FOR SUTURING LAPAROTOMY WOUND WITH MESH THREAD

Aim. Development of an alternative to preventive prosthetics method of primary closure of a laparotomy wound, superior in morphological and physical properties to the method of closure with traditional suture materials. Materials and Methods. The team of authors developed a method of laparorrhaphy, where the white line of the abdomen is sutured first with strengthening sutures with a mesh thread in places of highest tension, and then a continuous suture is applied. The effectiveness of this variant of wound closure was studied in a cadaver experiment and on tissues of laboratory pigs. In the course of the cadaver experiment, in 10 corpses of both genders a midline laparotomy was performed with suturing of the white line of the abdomen by the above-described technique with creation of intra-abdominal hypertension up to 140 mm Hg using a device designed for this. In the course of the experiment on animals, in 8 pigs under general anesthesia upper-median laparotomy up to the peritoneum 10-12 cm long was performed. The white line of the abdomen was sutured using the above-described technique with a mesh thread in the lower part of the wound. The upper part of the wound was closed with a checkerwise-reinforcing suture. At the second stage of the experiment, on the 14th day from the moment of the first operation, all animals were reoperated. A macroscopic assessment of the wound process was performed. Then the sutured sections of the aponeurosis were excised and subjected to strain gauge examination on an electronic dynamometer. For comparison, a similar study was carried out on an intact aponeurosis. Results. In the course of studies carried out on corpses, no cases of suture failure with the underlying created intra-abdominal hypertension were noted. The tensometry of the studied sutures proved that the initial strength of the reinforcing suture made of «mesh thread» was higher than that of one checker wise-reinforcing suture (tCt=27.053±0.745; p<0.01) and two nodal sutures (tCt=-18.834±0.582; p<0.01). On the 14th day, the strength of checkerwise-reinforcing suture was also lower than that of the reinforcing suture with a «mesh thread» (tCt=11.198±1.499; p<0.01). Conclusions. The method of suturing with «mesh thread» provides greater strength compared to other types of sutures due to good conditions for even distribution of the load on all suture stitches and the formation of a strong scar in the future.