A Comparative Study of the Figure of 8 Suturing Reinforced With Free Parietal Peritoneal Patch Versus Direct Suturing With Omental Plug/Falciform Plug in Patients With Gastro-Intestinal Perforation.

Abstract

Objectives: This present study was to compare the figure of 8 suturing reinforced with free parietal peritoneal patch versus direct suturing with omental plug/falciform plug in patients with gastro-intestinal perforation.
 Methods: A detail history, clinical examinations and relevant investigations were performed to all patients. All patients were anaesthetized: After painting and draping the operation site, right paramedian incision was made. Peritoneum was opened. Whole GIT and intra-abdominal organs were examined properly. Edges of perorated site were debrided. Then, the perforation firstly was stitched by a Figure of 8 stitch with vicryl 3-0 and then a free parietal peritoneal patch taken from lateral abdominal wall was applied and held in position with interrupted/continuous seromuscular sutures. Then, central tucking was also be done to keep the patch firmly fixed.
 Results: Data was analyzed by using SPSS version 26 software. One sample t test was applied. Mean and standard deviation were observed. P value was taken less than or equal to 0.05 for significant differences.
 Conclusions: Reinforcement of free parietal peritoneal patch over figure of 8 suturing is effective method for the closure of gastrointestinal tract perforations, with early evidence of gastrointestinal motility with oral intake allowed on an average 4th - 5th postoperative day was significant statistical difference with regards to complications like anastomotic leakage. Hence, the figure of 8 stitch reinforced with free parietal peritoneal patch is a simple and easy procedure with less hospital stay which does not require significant expertise and can even be performed in very short time by a trained general surgeon in a seriously ill patient in an emergency situation.
 Keywords: Gastrointestinal perforation, Figure of 8 stitch, parietal peritoneal patch, omental plug, direct suturing