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2019 | 91(5) | 12-20
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Single-Layer Sutures in Abdominal Cavity Surgery

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The aim of our study was to evaluate of short-term outcomes of 4210 patients who underwent open abdominal surgery with used either single-layer, absorbable, or continuous sutures. Seromuscular anastomosis were presented (without mucosa). Fluid therapy: GDT and zero-balance GDT were also discussed. Anastomosis leakage developed in 6 patients. They were treated by creating a stoma. Simultaneously, septic shock was treated. Re-anastomoses were performed after some time and after sepsis was suppressed. Results of treatment with use of double-layer sutures, which was is use before 1978, were presented. Analysis of 536 patients treated at the same time was conducted and 53 patients with anastomosis leakage was identified. Out of this group, 2 patients survived. Based on the literature review, the methods for performing anastomosis. Attention was paid to the advantages of single layer over multi-layer sutures: effectiveness, simplicity and lower cost of treatment. The occurrence of mechanical ileus was less frequently observed since ceasing to employ peritoneoplasty, and preoperational preparation of gastrointestinal tract in patients had a beneficial influence on their postoperative course. Postoperative complications were discussed mainly based on additional examinations such as TC and MRI. The attention was focused on the importance of medical observation and clinical examination by an experienced surgeon in order to identify postoperative complications. Antibiotic treatment in cases of postoperative complications was presented, as well as fluid therapy: GDT, zero-balance GDT and the procedures employed in cases of complications such as: anastomosis leakage, mechanical ileus, inter-peritoneal abscess. Anastomotic stenosis was not observed in this group of patients.
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