All-Around Transfixion Suture Technique
The "all-around transfixion suture" is not a standardized surgical technique recognized in contemporary surgical guidelines or literature. Based on available evidence, this term appears to be either outdated nomenclature or a misidentification of other established suture techniques. 1
Historical Context and Possible Interpretations
The term "transfixion" in surgical literature historically refers to:
- Transfixion incisions in rhinoplasty procedures, where incisions are made through the columella for access to nasal structures 2
- Transfascial suture techniques used in laparoscopic hernia repair, where sutures pass through fascial layers to secure mesh 3
Neither of these represents an "all-around" technique as the question implies. 2, 3
Modern Evidence-Based Suture Techniques
Contemporary surgical guidelines from the World Society of Emergency Surgery (2023) do not reference any "all-around transfixion" technique. Instead, they recommend specific, evidence-based approaches: 1
For Abdominal Wall Closure:
- Continuous suture technique is preferred over interrupted sutures due to faster closure time, with no difference in hernia or dehiscence rates 1
- Small bite technique (5mm from wound edge, 5mm between stitches) reduces incisional hernia compared to large bite technique 1
- Mass closure (single layer including all fascial layers) is faster than layered closure with equivalent outcomes 1
- Slowly absorbable monofilament sutures are recommended to reduce infection risk and maintain tensile strength 1
For Skin Closure:
- Continuous subcuticular sutures reduce superficial wound dehiscence compared to interrupted sutures 1
- Figure-of-eight sutures are specifically used for cartilage stabilization and hemostasis in vascular access sites, not general wound closure 4
Critical Distinction
If you are referring to retention sutures (also called "through-and-through" sutures), these pass through all layers of the abdominal wall outside the primary incision line. However, the 2023 World Society of Emergency Surgery guidelines found insufficient evidence to recommend routine use of retention sutures, with only 68% panel agreement on avoiding their routine use. 1
Retention sutures may be considered only in very high-risk patients with: 1
- Severe preoperative malnutrition
- Immunocompromised status
- Previous fascial defects
- Massive abdominal contamination
- Increased tension in the incision
Recommendation
Without clarification of what "all-around transfixion suture" specifically refers to, I cannot provide technique-specific guidance. If you are planning abdominal wall closure, follow the evidence-based continuous small-bite technique with slowly absorbable monofilament sutures and a suture-to-wound length ratio of at least 4:1. 1 If you are referring to a specific historical or regional technique, please provide additional context for accurate guidance.