Outcome Of Midline Laparotomy Wound Closure With Interrupted X-Suture Technique Versus Continuous Suture Technique In Mardan Medical Complex

Original Article

Abstract

Background: One of the procedures that the general surgery and gynecology departments do most often in emergency
cases is laparotomy. Wound closure is one of the key factors influencing how well this procedure works. While some
surgeons choose interrupted closure techniques, others favor continuous closure of the linea alba.
Objective: to evaluate the results of laparotomy wound closure in midline laparotomy patients using the interrupted
X-suture method versus the continuous suture technique.
Study design: Randomized Controlled Trial (RCT)
Duration and place of study : Medical Complex’s Department of General Surgery and Gynaecological participated in this randomized controlled trial. This study covered January 2018–December 2019
Materials & Methods: Adult emergency midline laparotomy patients at Mardan Medical Complex’s Department
of General Surgery and Gynaecological participated in this randomized controlled trial. This study covered January
2018–December 2019. Two hundred patients were studied. They were randomly divided into two groups. These
patients had their abdominal incisions sealed with continuous sutures. People in Group II had interrupted X-sutures
to close their abdominal wounds. Patients were evaluated daily for difficulties in the first week and after two weeks.
Results: Group I’s mean age was 43.8±8.7 years, whereas Group II’s was 42.6±10.9 years (p-value = 0.39).
In group I, there were 77% of male patients, while in group II, there were 74% (p-value 0.74). The most prevalent
etiology was peritonitis caused by a gut perforation, accounting for 63% of cases in group I and 68% in group II
(p-value = 0.55). 9.5% of patients in group I and 3.5% of patients in group II were diagnosed with laparotomy
wound dehiscence (p-value 0.006). Regarding other issues, no statistically significant difference was seen.
Conclusion: After an emergency midline laparotomy, the interrupted suture method (X-suture) is superior to the
continuous suture technique for closing the abdominal wall. The interrupted X-suture procedure has considerably
reduced the incidence of wound dehiscence.
Keywords: Acute abdomen, peritonitis, gut perforation, emergency midline laparotomy, and laparotomy wound
dehiscence.