Closing the Gap: Novel Abdominal Wound Closure Techniques.

ABSTRACT

Traditionally, surgical procedures within the realm of both general and gynecological surgery employ the use of staples and interrupted sutures that run continuously with knot tying or subcuticular sutures to ensure closure of large wound incisions, subcuticular incisions, and fascial repair. However, these methods may not always be cosmetically favorable and, thus, result in an unpleasant outcome for the patient, adding to their surgery-related stress. It is, therefore, imperative that surgeons and gynecologists are aware of alternative methods of wound closure that are not only cosmetically favorable, but also ensure rapid wound recovery and infection control. Two such products available include DERMABOND™ PRINEO™ Skin Closure System (Ethicon Inc., Somerville New Jersey) and STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device (Ethicon Inc., Somerville New Jersey). The DERMABOND™ PRINEO™ Skin Closure System is a topical mesh and skin adhesive that creates a strong polymeric bond across wound edges. This permits natural healing to occur, but with a synthetic flexible microbial barrier providing in vitro protection against organisms. The STRATAFIX™ Symmetric PDS™ Plus, on the other hand, is a knotless tissue control device that permits soft tissue approximation in appropriate situations where such absorbable sutures are permitted. This can be used for large fascial closure as well as on the skin. The purpose of this article is to review and share our experience with two alternative methods of wound closure (one for fascia and one for skin) with a review of their composition and benefits and to illustrate their common applications in gynecologic or general surgery when laparotomy is necessary.