A study to evaluate the effects of various abdominal closure techniques on midline laparotomy wounds in a tertiary care hospital in West Bengal

Abstract

Background: Post-operative complications of wound repair after laparotomy pose a major threat to life as well as to the health economy of a developing nation. Among many other factors, the length of suture used during wound closure has been studied for long. A prospective randomized control study comprising of 104 patients was conducted in the department of surgery of Bankura Sammilani medical college for comparing the incidence of SSI, wound dehiscence and incisional hernia after using short stitch and long stitch for repairing midline laparotomy wounds.Methods: Out of 104 patients enrolled in the study, 51 patients were randomly allocated to short stitch group (suture length: wound length>4:1) and 53 patients were allocated to long stitch group (suture length: wound length=4:1) and both the groups were subsequently followed up for development of the three complications.Results: Data analysis revealed that 11.7 % patients in short stitch group developed SSI whereas 24.5% patients in long stitch group developed SSI. Wound dehiscence occurred in 5.8 % of patients in short stitch group against 15% in long stitch group. 7.8% patients in short stitch group developed incisional hernia against 20.7% patients in long stitch group. In all three situations, p value was significant (<0.05).Conclusions: It is concluded from our study that, the rate of SSI, wound dehiscence and incisional hernia is significantly lower in midline abdominal wounds closed with short stitch length than those closed with long stitch length.