Comparing Simple Interrupted vs. Continuous Fascial Closure Methods in Elective Midline Laparotomy, a randomized controlled trial

Abstract

Abstract Background As a common complication of midline laparotomy, Incisional hernia (IH) imposes an additional cost on the healthcare system. The wound closure method has been considered one of the most critical risk factors for IH.Methods This randomized clinical trial was conducted on elective laparotomy patients between January 2018 and January 2019. All the patients were randomly allocated to two simple interrupted and continuous suture groups. All the surgeries were performed by a single surgeon and used PDS sutures. Demographic information and data on CBC, abdominal ultrasonography reports, and dehiscence or hernia were recorded in a pre-designed checklist. Patients were followed up for one year regarding surgery site pain and infection and the incidence of incisional hernia or fascia dehiscence.Results We analyzed 56 male and 34 female patients with a mean age of 49.53 ± 14.58 in two simple interrupted and continuous suture groups. After a one-year follow-up, 12 (26.6%) patients in simple interrupted and 9(20%) patients in the continuous suture group developed incisional hernia (p = 0.455). In addition, 5 (11.1%) patients in the simple and 3 (6.6%) patients in the continuous suture group had fascial dehiscence (p = 0.459). After the operation, 4(8.8%) patients in the simple and 3 (6.6%) patients in the continuous group developed wound infection (p = 0.694). In addition, there was no significant difference between the two groups on the pain scale following surgery (p = 0.262).Conclusions There are no significant differences between simple interrupted and continuous laparotomy incision closure methods regarding incisional hernia, fascial dehiscence, wound infections, and pain scale.