The impact of different suturing techniques for abdominal fascia closure on the Interleukin-6 expressions in Rattus norv
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BMC Research Notes Open Access
RESEARCH NOTE
The impact of different suturing techniques for abdominal fascia closure on the Interleukin‑6 expressions in Rattus norvegicus Heryu Prima1, Imam Sofii1*, Aditya Rifqi Fauzi2, Ishandono Dachlan3 and Gunadi2
Abstract Objective: Incisional hernia is a frequent complication of midline laparotomy. The suturing technique is an important determinant of the risk of developing an incisional hernia. Moreover, IL-6 has crucial roles in the wound-healing process. We aimed to compare the large stitch vs. small stitch technique for abdominal fascial closure on IL-6 expressions in rats. Results: Twenty rats were used. The small stitch group received small tissue bites of 5 mm and the large stitch group received large bites of 10 mm. The incisions of fascia were closed by running sutures. Animals were euthanized on days 4 and 7. Histological sections of the tissue-embedded sutures were analyzed for IL-6 expressions. Two-way ANOVA showed that rats in the small stitch group had similar IL-6 expressions on days 4 and 7 to those in the large stitch group (p = 0.36). In conclusion, the IL-6 expressions are similar between the small and the large stitch groups, implying that different suturing techniques might not have an impact on the incisional hernia occurrence. Keywords: Abdominal fascial closure, Interleukin-6 expression, Incisional hernia, Large stitch, Small stitch Introduction Incisional hernia is a frequent complication of postabdominal wall incisions and causes reoperation. In various meta-analysis and meta-regression studies, the mean incidence rate of incisional hernia at 23.8 months postabdominal incision was 12.8% [1]. The occurrence of an incisional hernia has an important impact on the quality of life and body image of the patient [2]. The estimated cost of incisional hernia management reaches billions of US dollars annually [3]. Therefore, to reduce the incidence rate of incisional hernia requires optimal closure of the abdominal wall incision in order to save both cost and use of health facilities and reduce postoperative disability [1]. *Correspondence: [email protected] 1 Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia Full list of author information is available at the end of the article
The median incision is the most commonly selected incision for open abdominal surgery [4]. A number of experimental and clinical studies have shown that the quality of stitching techniques is essential for the prevention of wound complications in the median incision [5]. Incisional hernia is the late complication of fascial disruption [6]. Fascia can more efficiently pick up and activate cellular elements that are important for the proliferative phase of the abdominal incision wound healing process. The proliferation phase of wound healing begins to dominate on the fourth day after the abdominal incision and fibroblasts are the most important cellular co
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