Comparison of Continuous and Interrupted Fascial Closure of Midline Laparotomy Wounds

Abstract

This study compares the effectiveness of continuous and interrupted fascial closure techniques in midline laparotomy wounds. Conducted over two years at the NRI Institute of Medical Sciences, the study involved 60 patients randomized into two groups of 30. Each patient underwent either continuous or interrupted suture closure using non-absorbable no. 1 prolene suture material. The primary aim was to evaluate post-operative complications such as wound infection, seroma formation, and wound dehiscence. Results indicated that the continuous closure technique was associated with higher rates of post-operative wound infection (33.3% vs. 13.3%) and seroma formation (36.7% vs. 10%) compared to the interrupted closure technique. Wound gaping and dehiscence were also more prevalent in the continuous closure group (28.1% and 30%, respectively), with statistically significant differences (p<0.05). The interrupted closure technique demonstrated superior effectiveness in reducing these complications. The follow-up period ranged from 7 to 14 months, during which no cases of incisional hernia were observed. These findings align with previous research, highlighting the increased risk of wound dehiscence in emergency laparotomies and patients in their 40s. Male patients exhibited a higher incidence of dehiscence, potentially due to a higher prevalence of risk factors such as peptic ulceration and intestinal obstruction. In conclusion, the interrupted suturing technique is associated with lower rates of wound dehiscence and related complications, suggesting it as the preferred method for midline laparotomy wound closure. These findings support the use of interrupted suturing for reducing post-operative complications. Further studies are recommended to explore the long-term outcomes of these techniques, ensuring the continued improvement of surgical practices and patient care in midline laparotomy wound management.