A Comparative Study Using Interrupted Figure of Eight Suture Versus Conventional Continuous Suturing for Closure of Emergency Midline Laparotomy

Abstract

Wound infections continue to represent a major medical problem, both in terms of how they affect the outcome of surgical procedures (surgical site infections), and for their impact on the length of hospital stay and medical costs. Many otherwise successful surgical operations fail because of the development of wound infections. A major SSI is defined as a wound that either discharges significant quantities of pus spontaneously or needs a secondary procedure to drain it Wound infection predisposes the patient to wound dehiscence. Acute wound failure is defined as postoperative separation of the abdominal musculoaponeurotic layers, within 30 days after operation. Most surgical wound infections become apparent within 7 to 10 days postoperatively. Objectives of the study 1. To assess local wound complication in emergency midline laparotomy wounds with interrupted figure of eight technique over conventional continuous closure . 2. To Compare the operative time for interrupted figure of eight closure and Conventional layered closure of laparotomy wounds. 3. To determine the factors affecting wound dehiscence. Materials and Methods: A prospective study was performed at Victoria hospital and Bowring and Lady Curzon hospital , Bangalore during November 2017 – May 2019. A sample of 100 cases were considered. Each Group consisted of 50. Group 1 underwent Interupted figure of Eight suture technique and Group 2 underwent continuous conventional suturing technique. Results: The incidence of burst abdomen in current study was 8%. There were two burst abdomen seen in conventional continuous closure technique and none in the interrupted figure of eight technique group. Conclusion: All the patients with generalized peritonitis in emergency setting need special attention regarding the wound closure. This newer technique of midline emergency laparotomy wound closure, especially in our part of the world significantly reduces the incidence of wound infection and wound dehiscence.