COMPARING THE EFFICACY OF MODIFIED CONTINUOUSSMEAD-JONES VERSUS CONVENTIONAL CLOSURE OFMIDLINE LAPAROTOMYWOUND

Abstract

Background: Disruption of abdominal incision is a serious event. Variousmethods have been employed in abdominal surgeries to close theabdominal wall.Abdominal wound dehiscence is a common complication of emergency laparotomy. Thereis an increase in the cost and hospitalstays. Prevention of this complication is important inreducingpost-operativemorbidity and mortality. Objectives: ThestudywascarriedoutintheDepartmentofGeneralSurgery,MMC&RI,Mysuru. 1. ToevaluateeffectivenessofmodifiedcontinuousSmead-JonesTechnique. 2. To compare effectiveness of modified continuous Smead-Jones withconventionaltechniqueofabdomenwoundclosureonthebasisofincidenceofwounddehiscence. Methods: The study was carried out on a total of 110 patients who were randomized intwo groups of 55 each. 55 patients underwent closure of mid line laparotomywound using modified continuous Smead-Jones technique(study group)and 55 patients underwent closure by conventionalmethod(control group). Results: The mean age group was 46 to 49. Male patients were more common comparedtofemale.Outofthevariouscausesofacuteabdomen,Prepyloricperforationwasthemostcommoncause,followedbyduodenalperforation.Outof 11 cases who had wound dehiscence,mostofthemwere for Pre pyloric perforation(55%), second most common was ileal perforation(27%). Patientswith risk factors had higher incidence of wound infection and wound dehiscence. Outof 110 patients, 32(29.1%) had wound infection, 12(21.8%) in the study group and20(36.3%) inthecontrolgroup.A total of 11(10%) patients had wound dehiscence, only 2 (3.6%) patients in the studygroup, whereas 9 (16.3%) in thecontrol group. Interpretationandconclusion:ModifiedSmead-Jonestechniquedecreasestheincidenceofwounddehiscenceand can be used to close the midline laparotomy wound in cases requiring emergencymidlinelaparotomy.