Why the study?
Does transverse laparotomy reduce wound healing complications compared to midline laparotomy in patients undergoing major abdominal surgery?
Does transverse laparotomy reduce wound healing complications compared to midline laparotomy in patients undergoing major abdominal surgery?
Transverse and midline laparotomy incisions have no significant difference in overall healing complications when wound sepsis is taken into account.
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Either incision acceptable when accounting for sepsis; confirms equivalence for healing complications in this RCT.
Five hundred and seventy-nine patients undergoing major laparotomy were randomly allocated to have midline or transverse incisions. Transverse incisions took longer to make and caused more bleeding but (in the absence of wound sepsis) no transverse wound burst and there were only 2 incisional hernias. In the midline group, without wound sepsis, there were 2 burst abdomens and 9 incisional hernias. When, however, those patients who suffered wound sepsis were also considered, there were no significant differences between the two groups.
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Greenall et al. (1980) studied this question.
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