Prevalence of Wound Infection With New Internal Tension Sutures Technique for Midline Laparotomy Closure

Abstract

Objective: To determine the incidence of wound infections in patients undergoing laparotomy closure using the internal tension sutures technique.

Methodology: This descriptive case series study was conducted at surgery department, JPMC, Karachi. Patients aged 18-50 years, undergoing laparotomy due to any one of perforated viscus, intestinal obstruction, stab wound to abdomen and other intra- abdominal malignancies of either gender were included. Patients underwent laparotomy under general anesthesia, with midline incisions, abdominal irrigation, and drain placement. Closure followed Jenkins' rule using continuous mass closure with Vicryl 1/0 and internal tension sutures. Skin was closed with staples or Prolene 2/0, and postoperative care included antibiotics, nutrition, and analgesics. Patients were followed weekly in OPD, and wound infections were assessed on the 15th postoperative day. Data was recorded by especially designed proforma.

Results: A total of 141 patients undergoing laparotomy were included in this study. Mean age, duration of surgery and weight in our study was 41.90±8.82 years, 105.11±12.25 minutes and 71.9±9.87 years. 69 (48.9%) were male and 72 (51.1%) were female. Out of 141 patients, 07 (5%) and 134 (95%) had and did not have 141 infection. Furthermore the stratification revealed no significant relationship of wound infection with age of the patients, gender, and the BMI, (p->0.05).

Conclusion: Study revealed that internal tension sutures technique reduce the incidence of wound dehiscence in abdominal surgery patients, it may cause postoperative pain and wound infection as evident from the results of our study and therefore should be cautiously applied in patients with a high risk.