• The primary outcome was the number of wound infections. [ Time Frame: 10 days after demission of patient from hospital ] [ Designated as safety issue: No ]
  

In our Department 839 operations were performed using a transverse abdominal incision between 10/03 and 10/07.

All patients were treated using clinical pathways (CP) to standardise surgical procedures in our high volume centre. Part of the clinical process management was the standardisation of wound incision and abdominal wall closure. Wound closure was achieved by a two-layer technique using continuous absorbable loop suture. The suture length to incision length ratio was at least 4:1. The running sutures were 1 cm apart and at least 1.5 cm from the wound edge 14. In the time between October 2003 and September 2005 (time period one, TP1), the CP step for fascia closure foresaw a PDS loop suture (PDS II®, 150 cm, Ethicon GmbH, Norderstedt, Germany). In October 2005, that CP step was altered to the use of a triclosan-coated polyglactin 910 loop suture (Vicryl plus®, 150 cm, Ethicon GmbH, Norderstedt, Germany). The primary outcome was the number of wound infections. Patients demographic and disease as well as procedure related data were collected in a clinical information system (ISHmed on SAP platform, GSD, Berlin, Germany) prospectively. Risk factors for poor wound healing, such as operation time, patients age, sex, body mass index, blood loss, peritonitis, antibiotics, and performance level classified according to the American Society of Anesthesiologists (ASA), were collected prospectively to compare the two groups.