Comparison of Laparotomy Wound Dehiscence (LWD) Rate Using Interrupted X-Suture Technique vs Continuous Suture Technique in Rectus Sheath in Emergency Laparotomy
DOI:
https://doi.org/10.52206/jsmc.2021.11.3.646Abstract
Background: Emergency laparotomy is one of the most commonly performed surgeries in emergency situations of general
surgery department. This can be performed for multiple causes. Wound closure is one of the main component of outcomes of this
surgery. Some surgeons prefer continuous closure ofthe linea Alba while other prefer interrupted closure technique.
Objective: To compare the frequency of laparotomywound dehiscence (LWD) using continuous suture technique with interrupted
X-suture technique inrectus sheath for emergency laparotomy wound closure.
Materials & Methods: This randomized controlled trial was conducted on adult patients who were planned for emergency midline
laparotomy in the department of general surgery of Saidu Group of Teaching Hospitals, Swat. The study was conducted from
January 2019 to November 2019. We included 200 patients and divided them into two equal groups. Group I; In these patients,
abdominal incision was closed using continuous suture technique.Group II; inthese patients, interrupted X-suture technique was
used for closure of abdominal wound incision. Patients were evaluated daily for 7 days and after that, at 15, h day, to diagnose the
wound dehiscence on clinical evaluation.
Results:Mean age was 43.8 ± 8.7 years in group I and42.6 ± 10.9 years in groupII(p-value 0.39). There were 77%male patients in
group I and 74% in group II (p-value 0.74). Peritonitis due to gut perforation was the commonest etiology, with 63% proportion in
group I versus 68% in group II (p-value 0.55). Laparotomy wound dehiscence was diagnosed in 15% patients in group I versus
3.0% patients in group II (p-value 0.006).
Conclusion: Interrupted X-suture technique is better than continuous suture technique for abdominal wall closure after
emergency midline laparotomy.Interrupted X-suture technique has significantly loweredthe frequency of wound dehiscence.
Keywords:Acute abdomen, emergency midline laparotomy,laparotomy wound dehiscence.
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