P-026 SMALL BITE CLOSURE IN EMERGENCY LAPAROTOMY; A RETROSPECTIVE COHORT ANALYSIS

Abstract

Abstract Aims To investigate the outcomes of the implementation of small bite closure in emergency laparotomy Methods A retrospective comparative cohort analysis was performed from Northumbria NHS Trust (United Kingdon) surgical database from 2017 to 2021. All cases of emergency laparotomy were included. Cases of open appendicectomy were excluded. Small bite closure was performed by a standardised technique with slowly absorbable sutures. A matched cohort of cases who were closed with mass closure were used for comparison. Results 262 cases of emergency small bites closure were included, and 247 cases of emergency mass closure. There were comparative age, sex and ASA grade in each group. There was no significant variation in the types of procedure performed. In the small bites closure group, there were 8 cases of superficial dehiscence (3%), 4 cases of deep dehiscence (1.5%) and 16 wound infections (6%). The mean post operative stay was 10 days (2 to 74). The 30 days mortality was 18 cases (7%) and 40 cases overall (15%). In the mass closure group, there were 6 cases of superficial dehiscence (2%), 6 cases of deep dehiscence (2%) and 23 wound infections (9%). The mean post operative stay was 14 days (3 to 65). The 30 day mortality was 34 cases (14%) and 65 cases overall (26%). Conclusion Small bites closure shows comparative results to mass closure in the emergency setting in post operative outcomes. Small bites closure is safe and feasible in the emergency setting.