“A COMPARATIVE STUDY OF SINGLE LAYER CLOSURE AND CONVENTIONAL LAYERED CLOSURE OF LAPROTOMY WOUNDS IN OUR INSTITUTE.”

Abstract

Background: Many of the operations performed by the general surgeons take place within the abdomen and consequently incision and suturing of the abdominal layers are the commonest exercises in operative surgery. Abdominal closure is very important as regards to incision, technique of repair and use of newer suture material, and has created a great interest to surgeons. Recent data suggests that technical factors are crucial and can be manipulated by the surgeon. Different suture techniques are used for closure of laparotomy wounds and each has its strong proponents. But the ideal method of abdominal wound closure is modied frequently. Commonly followed methods of abdominal closure are conventional layered closure and single layer closure. Since 1973, different workers have carried out comparative studies of these two methods with encouraging results and single layer closure was found to have denite advantages over conventional closure as regards to operating time, cost, feasibility, ease and postoperative morbidity. The present study is taken up to evaluate the advantages of single layer closure in comparison with the conventional layered closure on the basis of operative time, healing time and postoperative morbidity such as wound infection, burst abdomen and incisional hernia. To compare the techniques of single layer closure and conve Objective: ntional layered closure of laparotomy wounds on the basis of operative time and post- operative complications. Prospective study of 100 patients who un Methods: derwent laparotomy in CU Shah Medical College and Hospital, Surendranagar, for abdominal surgical problems needing either emergency or elective surgery was carried out after taking approval from ethical committee. Out of these 100 patients, 50 patients underwent laparotomy wound closure by single layer closure technique and the rest 50 patients by conventional layered closure technique. Time taken for closure of laparotomy wound was noted and patients were followed up post-operatively for any wound complications like seroma, wound infection, wound gaping, burst abdomen and incisional hernia. The mean time taken for closure of laparotomy wounds by single layer closure technique was 19 Results: minutes and by conventional layered closure technique was 27 minutes. There was a difference of 8 minutes which was statistically signicant (p=0.001). In the postoperative period, in patients who underwent single layer closure, totally 9 patients (18%) had post operative complications. In those 3 patients (6%) had seroma, 3 patients (6%) had wound infection, 2 patients (4%) had wound gaping, 1 patient (2%) had burst abdomen and none had incisional hernia. In patients who underwent conventional layered closure, totally 15 patients (30%) had post operative complications. In those 5 patients (10%) had seroma, 4 patients (8%) had wound infection, 3 patients (6%) had wound gaping, 2 patients (4%) had burst abdomen and 1 patient (2%) had incisional hernia. Laparotomy wound closure with single layer closure technique i Conclusion: s better than the conventional layered closure technique in terms of decreased operative time and also decreased postoperative complication