Comparison of Continuous Versus Simple Interrupted Polypropylene Suture Closure of Midline Emergency Laparotomy Wound in Terms of Wound Outcome in Adult Patients Presenting with Acute Abdomen
Continuous Vs Interrupted Polypropylene Suture Closure of Laparotomy Wound
DOI:
https://doi.org/10.54393/pjhs.v6i1.2634Keywords:
Simple Interrupted Suture, Continuous Closure Technique, Polypropylene, Midline LaparotomyAbstract
The best method and material for sutures to use while closing wounds are still unknown. This study aimed the results of this trial to determine which method works best and should be recommended as hospital policy. Objectives: To compare outcomes of simple interrupted versus continuous closure techniques using no.1 polypropylene sutures for emergency midline laparotomy wounds regarding frequency of wound dehiscence. Methods: This quasi-experimental study was conducted after obtaining approval from the College of Physicians and Surgeons Pakistan over six months from June 2024 to December 2024. 104 emergency midline laparotomy patients were recruited from the Surgical Department of Sir Ganga Ram Hospital, Lahore. Patients were divided into 2 groups A, continuous suture closure and Group B, simple interrupted suture closure. Postoperatively patients were observed for wound dehiscence. Data were analyzed using SPPS version 26.0. The occurrence of dehiscence was compared among groups using the chi-square test. Results: Wound dehiscence was found to be higher in Group A as compared to Group B. Group A: 21.1% vs. Group B: 11.5%, and p-value=0.185. Gender and Body mass index had no significant association with wound dehiscence in study groups. However, among the younger age group patients’ frequency of wound dehiscence was significantly higher while among the elderly age group, no significant difference was obtained. Conclusions: It was concluded that results of this study showed no significant difference for wound dehiscence for simple interrupted suture compared with versus continuous closure techniques using polypropylene suture for patients who underwent emergency midline laparotomy.
References
Mc Geehan G, Edelduok IM, Bucholc M, Watson A, Bodnar Z, Johnston A et al. Systematic Review and Meta-Analysis of Wound Bundles in Emergency Midline Laparotomy Identifies That It Is Time for Improvement. Life. 2021 Feb; 11(2): 138. doi: 10.3390/life11020138. DOI: https://doi.org/10.3390/life11020138
Lozada Hernández EE, Hernández Bonilla JP, Hinojosa Ugarte D, Magdaleno García M, Mayagoitía González JC, Zúñiga Vázquez LA et al. Abdominal Wound Dehiscence and Incisional Hernia Prevention in Midline Laparotomy: A Systematic Review and Network Meta-Analysis. Langenbeck's Archives of Surgery. 2023 Jul; 408(1): 268. doi: 10.1007/s00423-023-02954-w. DOI: https://doi.org/10.1007/s00423-023-02954-w
Sharma G, Prashar N, Gandotra N. Comparison of Suture Technique (Interrupted Vs. Continuous) With Respect to Wound Dehiscence. Indian Journal of Medical Sciences. 2020 Dec; 72(3): 191-4. doi: 10.25259/IJMS_21_2020. DOI: https://doi.org/10.25259/IJMS_21_2020
Chatterjee S and Bhattacharya T. A Study to Evaluate the Effects of Various Abdominal Closure Techniques On Midline Laparotomy Wounds in A Tertiary Care Hospital in West Bengal. International Surgery Journal. 2021 Mar; 8(4): 1129-33. doi: 10.18203/2349-2902.isj20210974. DOI: https://doi.org/10.18203/2349-2902.isj20210974
Isbell KD, Hatton GE, Wei S, Green C, Truong VT, Woloski J et al. Risk Stratification for Superficial Surgical Site Infection After Emergency Trauma Laparotomy. Surgical Infections. 2021 Sep; 22(7): 697-704. doi: 10.1089/sur.2020.242. DOI: https://doi.org/10.1089/sur.2020.242
Denys A, Monbailliu T, Allaeys M, Berrevoet F, van Ramshorst GH. Management of Abdominal Wound Dehiscence: Update of the Literature and Meta-Analysis. Hernia. 2021 Apr; 25: 449-62. doi: 10.1007/s10029-020-02294-4. DOI: https://doi.org/10.1007/s10029-020-02294-4
Rahman UA, Iftikhar MA, ul Miraj MZ, Butt MJ, Ahmed I, Yousaf H. Incidence of Wound Dehischence and Factors Causing Wound Dehiscence in Patients Undergoing Laparotomy in A Newly Established Surgery Department at A Tertiary Care Hospital. The Professional Medical Journal. 2023 Oct; 30(10): 1225-9. doi: 10.29309/TPMJ/2023.30.10.7710. DOI: https://doi.org/10.29309/TPMJ/2023.30.10.7710
Hermawan GN, Wibisono JJ, Nembo LF. Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice. Medicinus. 2021 Jun; 10(2): 102-10. doi: 10.19166/med.v8i3.3767. DOI: https://doi.org/10.19166/med.v8i3.3767
Bozzay JD, Walker PF, Schechtman DW, Shaikh F, Stewart L, Tribble DR et al Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group. Outcomes of Exploratory Laparotomy and Abdominal Infections Among Combat Casualties. Journal of Surgical Research. 2021 Jan; 257: 285-93. doi: 10.1016/j.jss.2020.07.075. DOI: https://doi.org/10.1016/j.jss.2020.07.075
Israr S, Khan MK, Farid A, Qaiser N, Akhtar K, Jalal A. Frequency of Abdominal Wound Dehiscence/Burst Abdomen in Patients of Laparotomy. Pakistan Journal of Medical and Health Sciences. 2022 Nov; 16(09): 772-. doi: 10.53350/pjmhs22169772. DOI: https://doi.org/10.53350/pjmhs22169772
Polychronidis G, Rahbari NN, Bruckner T, Sander A, Sommer F, Usta S et al. Continuous Versus Interrupted Abdominal Wall Closure After Emergency Midline Laparotomy: CONTINT: A Randomized Controlled Trial [NCT00544583]. World Journal of Emergency Surgery. 2023 Oct; 18(1): 51. doi: 10.1186/s13017-023-00517-4. DOI: https://doi.org/10.1186/s13017-023-00517-4
Gurjar V, Halvadia BM, Bharaney RP, Ajwani V, Shah SM, Rai S et al. Study of Two Techniques for Midline Laparotomy Fascial Wound Closure. Indian Journal of Surgery. 2014 Apr; 76(2): 91-4. doi: 10.1007/s12262-012-0612-7. DOI: https://doi.org/10.1007/s12262-012-0612-7
Kvist M, Jensen TK, Snitkjær C, Burcharth J. The Clinical Consequences of Burst Abdomen After Emergency Midline Laparotomy: A Prospective, Observational Cohort Study. Hernia. 2024 Oct; 28(5): 1861-70. doi: 10.1007/s10029-024-03104-x. DOI: https://doi.org/10.1007/s10029-024-03104-x
Luo W, Tao Y, Wang Y, Ouyang Z, Huang J, Long X. Comparing Running Vs Interrupted Sutures for Skin Closure: A Systematic Review and Meta‐Analysis. International Wound Journal. 2023 Jan; 20(1): 210-20. doi: 10.1111/iwj.13863. DOI: https://doi.org/10.1111/iwj.13863
Badkur M, Ram S, Patel S, Gupta A. Comparison Between Continuous Vs. Interrupted X-Suture for Midline Laparotomy Wound Closure. General Surgery: Open Access. 2020; 3(1): 12-4.
Belim O and Gohil K. Evaluation of Wound Dehiscence of Midline Laparotomy Wounds On Comparing Continuous Interlocking and Interrupted X-Suturing Methods of Closure. International Journal of Research Medicine. 2014; 3(2): 19-26.
Bansiwal RK, Mittal T, Sharma R, Gupta S, Singh S, Abhishek K et al. Comparative Study of Abdominal Wound Dehiscence in Continuous Versus Interrupted Fascial Closure After Emergency Midline Laparotomy. International Surgery Journal. 2019 Feb; 6(3): 886-91. doi: 10.18203/2349-2902.isj20190819. DOI: https://doi.org/10.18203/2349-2902.isj20190819
Bharti SV, and Sharma A. A Prospective Study Comparing Continuous Versus Interrupted Suture Techniques in Midline Abdominal Wound Closure. Journal of Nepalgunj Medical College. 2020 Dec; 18(1): 63-6. doi: 10.3126/jngmc.v18i1.35193. DOI: https://doi.org/10.3126/jngmc.v18i1.35193
Jhalani NK, Songra B, Jain R, Jain M, Sharma RL. Comparison of Suture Technique (Interrupted vs Continuous) Concerning Wound Dehiscence. Journal of Medical Science and Clinical Research. 2019 Feb; 7(2): 29-36. doi: 10.18535/jmscr/v7i2.07. DOI: https://doi.org/10.18535/jmscr/v7i2.07
Begum J, Ullah AF, Islam I, Chowdhury MA, Al Mansur MA, Das UK. Comparison Between Interrupted X Suture and Continuous Suture for Closure of Midline Incision in Emergency Laparotomy: A Randomized Controlled Trial. Chattagram Maa-O-Shishu Hospital Medical College Journal. 2022 Dec; 21(2): 52-6. doi: 10.3329/cmoshmcj.v21i2.63130. DOI: https://doi.org/10.3329/cmoshmcj.v21i2.63130
Sklar LR, Pourang A, Armstrong AW, Dhaliwal SK, Sivamani RK, Eisen DB. Comparison of Running Cutaneous Suture Spacing During Linear Wound Closures and the Effect On Wound Cosmesis of the Face and Neck: A Randomized Clinical Trial. Journal of American Medical Association Dermatology. 2019 Mar; 155(3): 321-6. doi: 10.1001/jamadermatol.2018.5057. DOI: https://doi.org/10.1001/jamadermatol.2018.5057
Eshagh K, Sklar LR, Pourang A, Armstrong AW, Dhaliwal H, Eisen DB. Interrupted Subcuticular Suture Spacing During Linear Wound Closures and the Effect On Wound Cosmesis: A Randomized Evaluator‐Blinded Split‐Wound Comparative Effectiveness Trial. British Journal of Dermatology. 2022 Sep; 187(3): 318-23. doi: 10.1111/bjd.21625. DOI: https://doi.org/10.1111/bjd.21625
Shimizu MR, Grayson W, Winfrey S, Brown NM. Wound Complication Rates After Anterior Total Hip Arthroplasty: A Case Series Comparison of Interrupted Vs. Continuous Sutures for Skin Closure. Journal of Orthopedics. 2025 May; 63: 130-4. doi: 10.1016/j.jor.2024.10.048. DOI: https://doi.org/10.1016/j.jor.2024.10.048
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