A Comparative Study Between Mass Closure Versus Conventional Layered Closure of Abdominal Wounds with Midline and Paramedian Incisions

• Main Author: M, Keshava Murthy
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2006
• Subjects: Abdominal surgery; Body fat; Connective tissue; Hernias; Infections; Laparotomy; Ligaments; Medical personnel; Medicine; Patient compliance; Pelvis; Penis; Sinuses; Surgeons; Surgery; Sutures; Turn of the century; Umbilical cord; Veins & arteries; Wound dehiscence
• ISBN: 9798380204897

BACKGROUNDThe ideal method of abdominal wound closure should be technically simple and it should be free from postoperative wound complications of wound infection, wound dehiscence, incisional hernia, suture sinus formation and should leave a reasonably aesthetic scar.The present study is a prospective comparative study between single layered closure versus conventional layered closure of ventral abdominal wounds with midline and para midline incisions, the study is conducted on patients admitted from November 2003 to April 2006 in the Department of Surgery, Bowring and Lady Curzon Hospitals, attached to Bangalore Medical College, Bangalore.OBJECTIVESThe objectives of the study is to find out the superiority of single layered closure over the conventional layered closure of ventral abdominal incisions in preventing post operative wound complications.METHODSOut of 109 major laparotomies from November 2003 to April 2006, 53 cases were randomized to have their ventral abdominal incisions closed by single layered closure and remaining 56 cases by conventional layered closure, they were grouped as Group I and Group II respectively, In Group I there were 6 cases (11.32%) of wound infection, 1 case (1.88%) of wound dehiscence, 1 case (1.88%) of incisional hernia, 2 cases (3.8%) of suture sinus formation and 5 cases (9.4%) of pain over the scar. In Group II there were 12 cases (21.42%) of wound infection, 4 cases (7.14%) of wound dehiscence, 2 cases (3.57%) of incisional hernia, 2 cases (3.6%) of suture sinus formation and 7 cases (12.5%) of pain over the scar.RESULTSThe current study has shown that the single layered closure technique of ventral abdominal incisions results in lower incidence of wound infection, wound dehiscence and incisional hernia as compared to conventional layered closure technique.INTERPRETATIONS AND CONCLUSIONSFinally, the observations tabulated from our comparative study proved to be similar to other studies conducted by various authors thus proving that single layered technique had the following advantages in:• Reduces the time consumed for closure. Closure is even more secure in cachectic patients and this allows early mobilization.•Reduces the incidence of wound infection, thus decreasing the hospital stay and morbidity.• Reduces the incidence of wound dehiscence.•Reduces the incidence of incisional hernia•Reduces the incidence of suture sinus formation and scar complications by using monofilament suture material.Thus, this method holds the promise for a safe technique of closure with minimal complication.