Evaluation of abdominal wall closure technique in emergency laparotomies at a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-2902.isj20162813Keywords:
Burst abdomen, Abdominal wound dehiscence, Emergency laparotomy, Clsosure techniqueAbstract
Background: Abdominal wound closure technique should be efficient to perform, provide strength and be a barrier to infection. The method of closure of the abdominal wall is a critical aspect of an effective incision closure, in addition to the choice of suture material. Abdominal wound dehiscence is a common complication of emergency laparotomy. This study was done to know whether our method of abdominal closure was helpful in reducing incidence of burst abdomen.
Methods: This retrospective study was carried out in the department of general surgery in a tertiary medical centre in Mumbai. 126 Patients undergoing emergency laparotomies for extensive generalised peritonitis through a vertical midline incision were included in this study; the indications for laparotomy were inflammatory, traumatic and neoplastic.
Results: Out of 126 patients undergoing closure of laparotomy wound by our method, wound infection was noted in 12 (9.52%) cases and 3 (2.38%) patients developed wound dehiscence (burst abdomen).
Conclusions: This retrospective study demonstrates that our method of abdominal closure was helpful in reducing the incidence of burst abdomen post-operatively. This is of extreme clinical importance in reducing morbidity, mortality and healthcare cost related to abdominal wound dehiscence in a patient undergoing emergency laparotomy.
Metrics
References
Israelsson LA, Millbourn D. Closing midline abdominal incisions. Langenbecks Arch Surg. 2012;397:1201-7.
Gislason H, Viste A. Closure of burst abdomen after major gastrointestinal operations-comparison of different surgical techniques and later development of incisional hernia. Eur J Surg. 1999;165:958-61.
Van RM, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J. Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg. 2002;89:1350-6.
Shukla HS, Kumar S, Misra MC, Naithani YP. Burst abdomen and suture material: a comparison of abdominal wound closure with monofilament nylon and chromic catgut. Indian J Surg. 1981;43:487-91.
Penninckx FM, Poelmans SV, Kerremans RP, Beckers JP. Abdominal wound dehiscence in gastroenterological surgery. Ann Surg. 1979;189:345-52.
Niggebrugge AH, Hansen BE, Trimbos JB, Velde CJ, Zwavelling A. Mechanical factors influencing the incidence of burst abdomen. Eur J Surg. 1995;161:655-61.
Diener MK, Voss S, Jensen K, Buchler MW, Seiler CM. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis Ann Surg. 2010;251:843-56.
Komba. Practices of abdominal fascial closure and related complications following elective midline laparotomy at Muhimbili National Hospital. Dissertation for M.Med (MUHAS). 2012:26-28.
Chawla S. A comparison between mass closure and layered closure of midline abdominal incisions. Med J. 2012;5:2627.
Knaebel HP, Koch M, Sauerland S, Diener MK, Buchler MW, Seiler CM, INSECT study group of the study centre of the German surgical society interrupted or continuous slowly absorbable sutures, multi-centre randomised trial to evaluate abdominal closure technique INSECT-trial. BMC Surg 2005;5:3.
Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: an evidence based review of the literature. J Curr Surg. 2005;62:220-5.
Weiland DE, Bay RC, Del Sordi S. Choosing the best abdominal closure by meta-analysis. Am J Surg. 1998;76:666-70.
Singh A, Singh S, Dhaliwal US, Singh S. Technique of abdominal wall closure: a comparative study. Indian J Surg. 1981;43:785-90.
Chowdhury SK, Choudhury SD. Mass closure versus layer closure of abdominal wound: a prospective clinical study. J Ind Med Assoc. 1994;92:229-32.
Rahman A. Spontaneous ileal perforation: an experience of 33 cases. J Postgrad Med Inst. 2003;17:105-110.
Downloads
Published
How to Cite
Issue
Section
