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Abdominal Wall Health

Abdominal Wall Closure

Main complications

Wound infections account for the most frequent postoperative complication.
Additionally burst abdomen is observed in 1 to 3 % of the patients within the first days after a midline laparotomy. [1]
We have to take into consideration that the incidence of incisional hernias 12±1 months postoperatively is estimated to be up to 20 % (range 9 to 20 %). [1]
Consequently, the problem of the therapy of the incisional hernia is not sufficiently solved, considering that up to every second patient suffers a relapse after its closure (range 30-49 %). [1]

Abdominal fascia healing period

Studies show that the Abdominal Wall fascia requires approximately two months to regain 50 % of its original strength. [2]
Extra-long term reliability is needed to facilitate a correct healing of the Abdominal Wall fascia.

Recommened technique and material

A recently published meta-analysis shows that an elective primary or secondary laparotomy through a midline incision has a relevantly lower chance of developing an incisional hernia if the abdominal fascia is closed with a continuous technique using slowly absorbable suture material. [3]

Special degradation profile

Its special degradation profile sustains 50% of its original strength for more than 3 months.* Accordingly Monomax® provides sufficient wound support during the healing process of the abdominal wall. [1]

Longitudinal elasticity

It’s all about “Shock-Z”: This unique Shock-Z feature provides wound compliance to acute or constant intra-abdominal pressure conditions. The ISSAAC study shows a tendency to lower values of complications after the usage of Monomax® for abdominal wall closure. [1]

Innovation

Smooth passage through the tissue and a degradation profile perfectly adapted to the tissue healing process, are just two examples of the many benefits that the new generation monofilaments present. But most importantly monofilaments present a “Less infection promoting effect”. [4], [5]

Abdominal wall strength recovery compared with Monomax®and poly-dioxanone suture degradation profile
Frequently used combinations
  • B0041119 Monomax® VIOLET 1 (4) 150CM HR48 LOOP
  • B0041222 Monomax® VIOLET 1 (4) 150CM HRT48 LOOP
  • B0041231 Monomax® VIOLET 1 (4) 200CM HRT48 LOOP
  • B0041077 Monomax® VIOLET 1 (4) 150CM HR40S LOOP
  • B0041138 Monomax® VIOLET 1 (4) 90CM HR48

[1] Albertsmeier M, Seiler CM, Fischer L, Baumann P, Hüsing J, Seidlmayer C, et al. Evaluation of the safety and efficacy of Monomax® suture material for abdominal wall closure after primary midline laparotomy-a controlled prospective multicentre trial: ISSAAC [NCT005725079]. Langenbecks Arch Surg. 2012 Mar;397(3):363-71.
[2] Rath A.M., Chevrel J.P. The healing of laparotomies: a bibliographic study Part two: technical aspects. Hernia 2000;4:41-48.
[3] Diener MK, Voss S, Jensen K, Büchler MW, Seiler CM. Elective midline laparotomy closure:
the INLINE systematic review and meta-analysis. Ann Surg. 2010 May;251(5):843-56.
[4] Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78.
5 Choi HJ, Chae HD. Comparison of E. coli infiltration between new synthetic absorbable sutures. J Jorean Surg Soc. 2009;77(1):1-6.

* Data on file

Abdominal wall health – It's all about prevention

Approximately 1.000.000 procedures are performed annually in Germany and 5.000.000 in the USA combining both open abdominal procedures and hernia repair procedures. Since the complications associated with these surgeries are becoming a top issue for the medical community, in B. Braun our goal is not only to work on repairing the abdominal wall but also to ensure its functionality and health for patients.

B. Braun offers a complete range of products for Abdominal Wall Health.

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