Comparação entre técnicas de fechamento de parede abdominal na incidência de hérnias incisionais: uma revisão sistemática

Abstract

Incisional hernias (HI) are defects in the abdominal wall that arise at the site of previous surgical incisions. During the primary closure of the wounds, continuous and interrupted sutures are used with absorbable and non-absorbable threads. The suture thread plays a role in maintaining tissue juxtaposition and in sustaining intra-abdominal pressures. This study aims to compare different suture techniques, and suture materials, in the incidence of incisional hernias and postoperative complications, which is essential to determine the ideal suture. This study is a literary review. Data collection occurred from the analysis of studies between 1983 and 2024, extracted from the MEDLINE, SciELO and Latin American Literature databases and LILACS. In the discussion of the article, continuous suture demonstrated advantages in emergency surgery environments due to the shorter exposure time of the patient. Absorbable monofilament yarns, such as polyglyconate, showed resistance and lower complication rates, but did not show significant differences in the incidence of hernias compared to non-absorbable wires. The use of triclosan in absorbable wires can reduce wound infections without significant impact on the HI rate. The study concludes that there is no definitive advantage of one suture technique over another in the prevention of incisional hernias, but continuous sutures are beneficial to reduce surgical time in emergencies. The choice of technique and suture material should balance the effectiveness in preventing hernias, minimizing complications and the clinical context of each patient.