A comparative study of modified Smead-Jones versus conventional continuous method in closure of the linea alba in case of emergency laparotomy
DOI:
https://doi.org/10.18203/2349-2902.isj20261571Keywords:
Emergency laparotomy, Linea alba closure, Modified Smead-Jones, Wound dehiscence, Randomized controlled trialAbstract
Background: Wound dehiscence following emergency midline laparotomy is a serious postoperative complication associated with increased morbidity, prolonged hospital stay, and incisional hernia risk. The optimal method for closing the linen alba remains controversial, particularly in contaminated and emergency settings. This study aimed to compare the effectiveness of the modified Smead-Jones technique with that of the conventional continuous closure method in preventing wound dehiscence following emergency laparotomy.
Methods: This single-center, single-blind randomized controlled trial was conducted over one year in a tertiary care hospital. A total of 132 patients who underwent emergency midline laparotomy were randomized in a 1:1 ratio to either modified Smead-Jones closure (Group B) or conventional continuous closure (Group A) of the linea alba. The primary outcome was the incidence of wound dehiscence within 30 postoperative days. Secondary outcomes included surgical site infection, need for secondary suturing, duration of hospital stay, and incisional hernia during the six-month follow-up. Statistical analysis was performed using SPSS version 21.0, with p<0.05 considered significant.
Results: Wound dehiscence occurred significantly more frequently in the conventional closure group than in the modified Smead-Jones group (21.2% vs. 7.5%, p=0.04). The rates of surgical site infection, requirement for secondary suturing, and incisional hernia were also significantly higher in the conventional closure group.
Conclusions: The modified Smead-Jones technique significantly reduced the incidence of wound dehiscence and postoperative complications compared to conventional continuous closure in emergency laparotomy and should be considered a preferred method in high-risk emergency settings.
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