Comparative study of abdominal wound dehiscence in continuous versus interrupted fascial closure after emergency midline laparotomy

Bansiwal, Rajesh Kumar; Mittal, Tarun; Gupta, Sanjay; Singh, Simrandeep; Kumar, Abhishek; Attri, Ashok Kumar

doi:10.18203/2349-2902.isj20190819

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…According to different studies documented incidence of wound dehiscience in emergency laparotomies was 20.01% and elective laparotomies was 3.3%. 11,12 In our study wound dehiscience was seen in 8.7% patients having emergency laparotomies as compared to 1.6% in elective laparotomies. These high incidence in emergency procedures were due to presence of peritonitis and poor nutritional status of the patients presenting in emergency department.…”

Section: Discussionmentioning

confidence: 48%

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Incidence of wound dehischence and factors causing wound dehiscence in patients undergoing laparotomy in a newly established surgery department at a tertiary care hospital.

Usman Ali Rahman,

Muhammad Adil Iftikhar,

Mohammad Zia ul Miraj

et al. 2023

TPMJ

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Objective: Wound dehiscence is a major complication of laparotomy procedure. It is more common in emergency procedure as compared to elective procedures. This wound dehiscence results in increase in both morbidity and mortality. Study Design: Cross Sectional study. Setting: Department of General Surgery, Gulab Devi Hospital Lahore. Period: January 2022 to December 2022. Material & Methods: All the patients undergoing laparotomy were included in this study through non randomized purposive sampling after their consent. Total of 86 patients were included in this study. Results: The mean age of patients were 35.66 ± 15 years. The mean BMI was 19.99±4.201 Kg/m2. Among these patients emergency procedures were performed in 23 (26.7%) while elective cases were 63 (73.2%). Incidence of wound dehiscence was 3.03%. Percentage of wound dehiscence was more in emergency procedure as compared to elective 8.7% versus 1.6% respectively. Conclusion: On the basis of this study we conclude that the wound dehiscence is more in patients treated in the emergency as compared to elective procedures. Wound dehiscence occurred more commonly among patient that had low BMI, anemia, malignancy, hypoproteinemia and peritonitis.

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Section: Discussionmentioning

confidence: 48%

“…According to Bansiwal et al the incidence of wound dehiscence in continuous closure technique was 20.1% versus 5.4% in interrupted method. 11 In our study all abdominal closure were done using continuous method with polypropylene 1 suture. Mostly wound dehiscence occurs between 3 rd to 5 th postoperative days.…”

Section: Discussionmentioning

confidence: 99%

Incidence of wound dehischence and factors causing wound dehiscence in patients undergoing laparotomy in a newly established surgery department at a tertiary care hospital.

Usman Ali Rahman,

Muhammad Adil Iftikhar,

Mohammad Zia ul Miraj

et al. 2023

TPMJ

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“…In the study by Bansiwal et al 20.1% of patients in continuous group developed wound dehiscence, while 5.4% patients in the interrupted group developed wound dehiscence. 12 Peter et al compared continuous versus interrupted technique for closing abdominal incisions. The patients who underwent midline incisions, the dehiscence rate was 2% for the continuous group versus 0.9% for interrupted group with no statistically significant difference between them.…”

Section: Discussionmentioning

confidence: 99%

Comparison of continuous versus interrupted abdominal fascia closure using polydioxanone suture in laparotomy

Sharma¹,

Gupta²,

Singh³

et al. 2019

Int Surg J

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Background: Laparotomy is a major surgical procedure in emergency settings. There is paucity of data regarding abdominal fascia closure in emergency laparotomies in Indian population. This study was planned to compare two techniques of fascial closure namely continuous and interrupted using polydioxanone in patients undergoing midline emergency laparotomies in our institute.Methods: This prospective study was conducted in Surgery Department, MMC&H, Muzaffarnagar, from January 2017 to June 2018. 60 patients undergoing emergency laparotomies were divided into two groups of 30 each. Group I (study group) patients underwent interrupted suture abdominal closure; Group II (control group) patients underwent continuous suture closure.Results: Commonest diagnoses were duodenal and enteric perforations. Mean closure time in Group 1 was 31.6 minutes and in Group 2 -17.3 minutes. Mean hospital stay in Group I and II were 12.88 and13.76 days respectively. 4 Group I patients developed wound discharge versus 6 patients in Group II. Burst abdomen occurred in 3 out of 60 patients. One Group I patient had localised fascial burst. One Group II patient had localized while one had complete fascial burst. One incisional hernia was observed in each group at 3rd month of follow up. Three patients in Group 1 and one in Group 2 developed suture sinus.Conclusions: Major complication is wound dehiscence leading to increased morbidity, hospital stay and cost. In our study, we used continuous and interrupted PDS sutures and found that interrupted suturing method of abdominal wall closure is better, though it takes more time.

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“…According to Bansiwal et al [ 6 ] study, the incidence of abdominal wound dehiscence in emergency laparotomy with continuous closure was 20.1% and that of interrupted closure technique (since Hughes repair is also a type of interrupted closure) was 5.4%. We used the formula below to calculate the sample size.…”

Section: Methodsmentioning

confidence: 99%

Hughes Abdomen Closure Technique Versus Continuous Closure in Emergency Midline Laparotomy: A Randomized Controlled Study

Murthy,

Neogi,

Roy

et al. 2024

Cureus

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Background Abdominal wound dehiscence, a serious postoperative issue, remains a significant concern for surgeons due to its potential to increase patient mortality and morbidity. Disruption can occur at any point after surgery, sparking debate over the optimal closure method for midline vertical abdominal wounds. Therefore, it's crucial to determine the safest approach. Our randomized clinical trial is planned to compare the risk of a burst abdomen associated with the Hughes abdominal closure technique to that of continuous abdominal closure. Methods All patients >18 years scheduled for emergency midline laparotomy were randomly assigned into two groups using computer-generated random numbers: Group A underwent Hughes repair (12 patients) and Group B underwent continuous closure (17 patients). Preoperative data, including patient demographics, and postoperative outcomes, such as time for rectus closure, wound dehiscence, surgical site infection (SSI), and length of hospital stay, were documented for analysis. Results The study found that the average patient age was 37.89 years, with more males than females. Both groups had an equal distribution of co-morbidities (p = 0.468), but none of these factors were statistically significant. Burst abdomen occurred in 25% of group A and 41.1% of group B (p = 0.367, not significant). Incisional hernia was absent in both groups. Surgical site infection (p = 0.119) and respiratory complications (p = 0.16) were not statistically significant between groups. However, in group A, the regressive analysis showed significant associations between burst abdomen, surgical site infection (p = 0.018), and respiratory complications (p = 0.007), while in group B, these associations were not significant (p = 0.252 for SSI and p = 0.906 for respiratory complications). Conclusion The occurrence of burst abdomen and closure time differences between continuous and Hughes techniques were not significant. The Hughes technique was quicker to learn (32 vs. 22 minutes). Burst abdomen was more common in continuous closure (group A: 25% vs. group B: 41%), favoring the Hughes technique. Factors like age, gender, and others didn't significantly impact the burst abdomen in either group.

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Comparative study of abdominal wound dehiscence in continuous versus interrupted fascial closure after emergency midline laparotomy

Cited by 6 publications

References 11 publications

Incidence of wound dehischence and factors causing wound dehiscence in patients undergoing laparotomy in a newly established surgery department at a tertiary care hospital.

Incidence of wound dehischence and factors causing wound dehiscence in patients undergoing laparotomy in a newly established surgery department at a tertiary care hospital.

Comparison of continuous versus interrupted abdominal fascia closure using polydioxanone suture in laparotomy

Hughes Abdomen Closure Technique Versus Continuous Closure in Emergency Midline Laparotomy: A Randomized Controlled Study

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