One Year Randomized Control Study to Compare the Efficiency of Continuous Versus Interrupted Abdominal Fascia Closure in Patients Undergoing Laparotomy Using Polydioxanone Suture in KLES Dr. Prabhakar Kore Hospital and Research Centre, Belagavi

Abstract

Background and objectives The high combined incidence of surgical site incision (SSI), wound dehiscence and hernia formation indicates a dominant contribution of wound complications to surgical morbidity. Primary objective is to compare the efficiency of continuous versus interrupted abdominal fascia closure using PDS suture in terms of wound dehiscence and to adopt a better technique of closing abdominal fascia so as to prevent the surgical wound dehiscence and burst abdomen. Methodology The present one year randomized control study was undertaken in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from period January 2017 to December 2018. A total of 60 patients undergoing elective mid-line laparotomy were selected for the study. Post-operatively wound was examined on POD-03 and followed up at 1 week, 3 week, 6 week, 3 months and once in a month for a period of 6 months after surgery on OPD basis particularly to look for any suture sinus formation, surgical site infection, wound dehiscence or incisional hernia. Results Majority of patients in group A were males- 53.33% compared to females-46.67%, whereas majority of patients in group B were females-53.33% compared to males-46.67%. Surgical site infection in group A is 13.3% and in group B is 10.00%, which was statically not significant (p value-0.6876). Wound dehiscence rate in group A and B is 10% and 6.67% respectively, which is statistically not significant (p value-0.6406). The incidence of Incisional hernia in the study is zero in both the groups. Conclusion and interpretation Continuous suturing is comparable to interrupted suturing in terms of occurrence of wound infection, wound dehiscence and incisional hernia. Continuous closure is better than interrupted closure as it is faster, takes less suture material and there is no suture sinus formation. But, most of the time the technique of closure depends on the surgeon’s choice and convenience. PDS can be considered as an ideal suture material for abdominal fascia closure due to its delayed absorbable property with significant reduction in the incidence of wound dehiscence.