Navigation Links
The decision about the incision: Is midline or transverse better for abdominal surgery?
Date:6/30/2009

An unusual study at the Department of Surgery at Heidelberg University Hospital examined for the first time whether the incision technique used in major abdominal surgery had an effect on the results. Neither physician nor patient knew what kind of incision had been made. The study of 200 patients showed that pain perception and the healing process were unrelated to the technique used to open the abdominal cavity. Complications were also just as frequent, except for wound infections, which were more frequent for transverse incisions, possibly due to circulatory problems. The surgeons in Heidelberg thus recommend that the surgeon make an individual, case-by-case decision on the incision technique.

The incision technique has thus far never been examined scientifically

Today, abdominal surgery is often done in a minimally invasive procedure using "keyhole surgery". But for large operations, the abdomen must still be opened with a long incision. "Whether this incision is transverse or midline depends mainly on the surgeon's preference and has thus far never been examined scientifically," Professor Markus W. Bchler, Director of the Department of Surgery at Heidelberg University Hospital.

This randomised trial was carried out according to international quality criteria to clarify definitively whether the two methods are equivalent and the surgeon is thus free to choose a technique, said Dr. Christoph Seller, consultant at the Department of General, Visceral, and Transplant Surgery and Chairman of the Study Center of the German Surgical Society in Heidelberg. The study was published in June 2009 in the "Annals of Surgery," the most important international journals for surgery.

How can a surgical trial be "blinded"?

A high quality clinical study on evaluating various therapies is done as a "double blind" study. This means that neither patient nor physician or nursing staff know what treatment a patient is given. The surgeon who performs the operation does not participate in gathering data. While still in the operating theater, a dressing is put on the patient, which is not removed until two days after the operation. Before it is removed, the amount of pain medication that was given is calculated and the patient assesses the pain using a scale. "The patients have no way of knowing how they were operated on," reports Dr. Seiler.

The consumption of pain medication and degree of pain immediately after the operation were the same for both procedures. There were also hardly any differences in long-term complications: The patients were examined twice, one month and one year after the surgery. The investigators tested possible consequences of the operation such as mortality, respiratory problems, digestive problems, length of hospitalization, scar ruptures, and wound infections. Statistically, there were no differences between the two groups only wound infections were significantly more frequent for transverse incisions.

Dr. Seiler says, "This is difficult to explain. Perhaps it is linked to less control of bleeding or the higher risk of hematoma." He added that previous studies had not indicated a higher risk. The surgeons in Heidelberg thus draw the conclusion that there is thus a scientific basis for allowing the surgeon the free choice of incision technique.


'/>"/>

Contact: Dr. Christoph M. Seiler
christoph.seiler@med.uni-heidelberg.de
062-215-66980
University Hospital Heidelberg
Source:Eurekalert  

Related medicine news :

1. Jeff Stewart Joins Decision Resources, Inc. as Chief Information Officer
2. Decision tool for prostate cancer patients helps men customize treatment in anxious time
3. Bionovo Announces Arbitration Decision in Lawsuit Filed by Former Officer - All Claims Denied
4. Patients Say Costs Determining Factor in Their Treatment Decisions
5. CMS Decision - No Material Financial Impact to Medicsight
6. DATATRAK Announces Receipt of NASDAQ Panel Decision to Delist Common Shares
7. MEDRAD Introduces Manage.Report - Advances Evidence-Based Decision Making
8. Religious devotion does not impact abortion decisions of young unwed women
9. Carefx's Newest White Paper Illuminates Healthcare CIOs' Growing Role in Operations, Strategic Thinking and IT Project Decision Making
10. Nurse Response Partners With Healthwise to Help Consumers Make Informed Decisions on Health
11. Carefxs Newest White Paper Illuminates Healthcare CIOs Growing Role in Operations, Strategic Thinking and IT Project Decision Making
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
The decision about the incision: Is midline or transverse better for abdominal surgery?
(Date:2/26/2017)... ... February 26, 2017 , ... ODH, Inc.™ announced today it will ... the Sheraton Pentagon City Hotel in Arlington, VA. ODH’s director of medical strategy, Candace ... analytics to improve Medicaid population health management. , ODH will also have an exhibit ...
(Date:2/25/2017)... ... February 25, 2017 , ... FCPX users now have ... from Pixel Film Studios. With ProSharpen Color users have total control over sharpening amount, ... their color range. With color spectrum tools users can visually see the color range ...
(Date:2/24/2017)... ... February 24, 2017 , ... Only two months after the official release of ... in Cannes (France), XO Private has initiated a second print-run of its lavish luxury ... a metre across when open, weighs in at more than six kilos, retails at ...
(Date:2/24/2017)... ... ... Dr. Ronald E. Hawkins, vice president for academic affairs ... Bell, DO, MBA, HPF, FACOEP-dist., FACEP, as the new dean of Liberty ... to Liberty from the Ohio University Heritage College of Osteopathic Medicine (OU-HCOM), where ...
(Date:2/24/2017)... ... February 24, 2017 , ... With millions of ... critically important that we all are aware of our options and are empowered ... to announce the launch of its newest edition of "Vision and Hearing" in ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... CUPERTINO, Calif. , Feb. 24, 2017  In ... fourth quarter 2016 financial results press release, you are ... be broadcast live over the internet on Tuesday, March ... Pacific Time). A live audio webcast of ... at www.durect.com and clicking "Investor Relations."  If ...
(Date:2/24/2017)... Report analyzes the worldwide markets for Endodontic Supplies ... the US, Canada , Japan ... , Latin America , and Rest ... period 2015 through 2022. Also, a six-year historic analysis is ... from primary and secondary research. Company profiles are primarily based ...
(Date:2/24/2017)... NEW YORK , Feb. 23, 2017  This ... US$ Thousand by the following Products: ... analyzed in the report include Pharmaceuticals, and Agrochemicals. The ... Japan , Europe , ... provided for the period 2015 through 2022. Also, a ...
Breaking Medicine Technology: