None listed
Conditions
Brief summary
The main aim of this study is to determine if the reinforced tension line (RTL) closure suture technique to close the abdominal incision during liver transplantation will reduce the rate of incisional hernia when compared to the standard suture closure technique. The study will provide the liver transplant surgeons with information about which technique is better to close the abdominal muscle (fascia). Currently, there is no prior study comparing these two surgical techniques in the liver transplantation group. The RTL technique has shown to be safe and effective in reducing hernias in other abdominal surgery (such as for bowel surgery operations). This is a prospective single centre randomised controlled clinical trial.
Interventions
The intervention is - Reinforced tension line suture closure of the abdominal fascia (description below)
Intervention Group:
- Reinforced tension line closure suture
o 5mm of fascia exposed on either side.
o “the reinforced tension suture”- Longitudinal suture using 2-0 PDS placed 3-5mm away from fascial edge on either side and each suture bite 10mm apart.
- The parallel RTL suture will go through both anterior sheath and posterior sheath (avoiding the muscle) in a midline closure (on either
The intervention is - Reinforced tension line suture closure of the abdominal fascia (description below) Intervention Group: - Reinforced tension line closure suture o 5mm of fascia exposed on either side. o “the reinforced tension suture”- Longitudinal suture using 2-0 PDS placed 3-5mm away from fascial edge on either side and each suture bite 10mm apart. - The parallel RTL suture will go through both anterior sheath and posterior sheath (avoiding the muscle) in a midline closure (on either side of the fascia) - In the transverse component of the wound – we will perform a two layered closure o we will utilise a parallel RTL suture for the posterior sheath first (on either side of the fascia). Once the posterior sheath/muscle of the transverse component is closed we will move onto closure of anterior sheath/muscle with another parallel RTL suture ( on each side) - Followed by continuous closure of fascia with 2 x 0 PDS suture with 5-10mm bites of fascial edge, with 5-10mm between each suture ensure sutures go beyond the longitudinal reinforced suture line This will be performed by the Liver Transplant surgeon for all recruited patients undergoing Liver Transplantation. We will review operative notes to monitor adherence .
Sponsors
Sydney Local Health District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients undergoing liver transplantation for any indication Participants need to have ability to provide consent or have a person responsible willing to consent. They must be willing to participate and comply with study requirements
Exclusion criteria
• Patients with open abdomen – i.e fascia not closed at time of surgery
Outcome results
None listed