Prophylactic Retention Sutures in Midline Laparotomy in High-Risk Patients for Wound Dehiscence: a Randomised Prospective Case Control Study

Abstract

Abdominal wound dehiscence (AWD) is one of the most notorious complication after laparotomy and associated with high morbidity and mortality. The retention suture is used in the re-operated cases of wound dehiscence to reduce the disruption of fascia. To study the effect of prophylactic retention sutures in patients with high risk for wound dehiscence who underwent midline laparotomy. Random selection of 200 midline laparotomy cases was done divided into two groups. In the one group (Cases- group A) Conventional mass closure of midline fascial wound closure with incorporation of prophylactic retention sutures. In other group (Control group - group B) midline line fascial closure by conventional mass closure without incorporation of prophylactic retention sutures. Comparison of both the techniques regarding preoperative status and postoperative complication such as incisional hernia, wound dehiscence and chronic wound pain was done according to clinical examination and recorded in the pro forma prepared. Incorporation of prophylactic retention sutures reduce the occurrence of WD following midline laparotomy in high-risk patients with multiple risk factors for impaired wound healing without imposing remarkable post-operative complications.