Comparison of suture technique (interrupted vs. continuous) with respect to wound dehiscence

Abstract

Objectives: Post-operative complete wound dehiscence, being an unfortunate and also a very serious complication, is associated with a high morbidity and mortality rate despite the most sophisticated intensive care these patients receive today. The quest for the best closure technique for abdominal incisions continues. To achieve this goal, several modifications in opening the abdomen and closing the wound have been tried. There are many studies in the literature comparing various methods of wound closure, with conflicting results. The aim of the present study was to assess the proportion of wound infection and wound dehiscence in the post-midline laparotomy patients, using interrupted X suture versus continuous suture technique in sheath closure. Material and Methods: A total of 80 patients undergoing vertical midline emergency laparotomy at one of the gynecology units were recruited randomly after taking written informed consent and were equally divided into 40 cases each group (interrupted X suture) and (continuous suture) they were randomized into two groups depending on whether the patient registration number was odd or even. Results: The age of the patients varied from 16 years to 82 years. In Group A, the mean age was 36.75 ± 13.78 years, and in Group B, the mean age of the patients was 38.37 ± 12.56 years. In Group A, 8 (20%) patients had comorbidity, whereas, in Group B, 10 (25%) patients had comorbidity. In Group A, 12 patients had wound infection, while in Group B, ten patients had wound infection (P = 0.001 [statistically significant]). In Group A, two patients had wound dehiscence, while none of the patients in Group B had wound dehiscence (P = 0.001 [statistically significant]). There was no incisional hernia in both the groups. Conclusion: Emergency laparotomy is associated with a higher rate of burst abdomen as compared to elective laparotomy, but using interrupted X suture technique in sheath closure, wound dehiscence can be prevented up to some extent.