Single- vs multiple-layer wound closure for flank incisions: results of a prospective, randomised, double-blinded multicentre study
Objective To compare the incidence of postoperative flank bulges between patients with multiple-layer closure and single superficial-layer closure after retroperitoneal surgery via open flank incision in the SIngle versus MUltiple-LAyer wound Closure for flank incision (SIMULAC) trial. Patients and...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2021
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| In: |
BJU international
Year: 2021, Volume: 127, Issue: 1, Pages: 64-70 |
| ISSN: | 1464-410X |
| DOI: | https://doi.org/10.1111/bju.15148 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/https://doi.org/10.1111/bju.15148 Verlag, lizenzpflichtig, Volltext: https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.15148 
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| Author Notes: | Maximilian C. Kriegmair, Nina Younsi, Kiriaki Hiller, Conrad Leitsmann, Karl F. Kowalewski, Fabian Siegel, Martin Rothamel, Manuel Ritter, Christian Bolenz, Martin Kriegmair, Lutz Trojan and Maurice S. Michel |
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| 245 | 1 | 0 | |a Single- vs multiple-layer wound closure for flank incisions |b results of a prospective, randomised, double-blinded multicentre study |c Maximilian C. Kriegmair, Nina Younsi, Kiriaki Hiller, Conrad Leitsmann, Karl F. Kowalewski, Fabian Siegel, Martin Rothamel, Manuel Ritter, Christian Bolenz, Martin Kriegmair, Lutz Trojan and Maurice S. Michel |
| 246 | 3 | 3 | |a Single- versus multiple-layer wound closure for flank incisions |
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| 520 | |a Objective To compare the incidence of postoperative flank bulges between patients with multiple-layer closure and single superficial-layer closure after retroperitoneal surgery via open flank incision in the SIngle versus MUltiple-LAyer wound Closure for flank incision (SIMULAC) trial. Patients and Methods The study was a randomised controlled, patient- and assessor-blinded, multicentre trial. Between May 2015 and February 2017, 225 patients undergoing flank incisions were randomised 1:1 to a multiple-layer closure (SIMULAC-I) or a single superficial-layer closure (SIMULAC-II) group. The primary outcome was the occurrence of a flank bulge 6 months after surgery. Results Overall, 177 patients (90 in SIMULAC-I, 87 in SIMULAC-II) were eligible for final assessment. The cumulative incidence of a flank bulge was significantly higher in the SIMULAC-II group (51.7%) compared to the SIMULAC-I group [34.4%; odds ratio (OR) 2.04, 95% confidence interval (CI) 1.11-3.73; P = 0.02]. Rate of severe postoperative complications (4.4% SIMULAC-I vs 10.3% SIMULAC-II; P = 0.21) or hernia (6.7% SIMULAC-I vs 10.3% SIMULAC-II; P = 0.59) was similar between the groups. There was no difference in pain (visual analogue scale) and the requirement for pain medication at 6 months postoperatively. Quality of life assessed with the European Quality of Life 5 Dimensions Questionnaire was higher in the SIMULAC-I group compared to the SIMULAC-II group at 6 months postoperatively, with a (median range) score of 80 (30-100) vs 75 (5-100) (P = 0.012). Conclusion The overall risk of a flank bulge after flank incision is high. Multiple-layer closure after flank incision should be performed as a standard procedure. | ||
| 650 | 4 | |a #uroonc | |
| 650 | 4 | |a flank bulge | |
| 650 | 4 | |a flank incision | |
| 650 | 4 | |a nephrectomy | |
| 650 | 4 | |a partial nephrectomy | |
| 650 | 4 | |a retroperitoneal surgery | |
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