Khirurgiia (Mosk). 2026;(10):43-50. doi: 10.17116/hirurgia202610143.
ABSTRACT
OBJECTIVE: To analyze the influence of local and systemic factors on reparative processes of laparotomy wound for optimized choice of abdominal closure strategy.
MATERIAL AND METHODS: A retrospective analysis enrolled 62 patients with penetrating abdominal wounds. Local (intra-abdominal complications, risk of abdominal compartment syndrome, number of relaparotomies) and systemic (total blood protein and urea) factors were assessed.
RESULTS: Statistical analysis revealed predictors of suture failure. Independent risk factors of aponeurotic suture failure were serum urea (odds ratio 0.754; p=0.020) and total protein (odds ratio 1.195; p=0.028) upon abdominal closure. Local factors (surgical site infection, peritonitis, abdominal compartment syndrome) were absolutely associated with failure (p<0.001).
CONCLUSION: A formalized algorithm consistently evaluates local factors and serum protein/urea with high predictive value of positive result (91.11%). Original algorithm objectifies the choice of abdominal closure strategy (primary suturing, controlled negative pressure or programmable hernia) and minimizes the risk of suture failure.
PMID:42831332 | DOI:10.17116/hirurgia202610143