Efficacy of prophylactic retention suture in prevention of wound dehiscence in emergency exploratory laparotomy- A prospective study

Abstract

Introduction: Exploratory laparotomy is routinely performed emergency surgery. Wound dehiscence is the most serious postoperative complications associated with high morbidity and mortality with incidence of 0.4%-3.5% and mortality of 10%-45%. By transmitting closing forces at the edge of fascia to the different abdominal layers using non-absorbable suture incidence of wound dehiscence can be reduced and retention sutures is one of the recommended technique for same. The aim of this study was to assess the reduced rate of dehiscence in midline laparotomy using prophylactic retention sutures in high-risk patients. Objectives 1) To perform normal wound closure in control group. 2) To perform prophylactic retention suture in intervention group. 3) To compare efficacy of the retention suture in prevention of wound dehiscence. Methods: 50 patients who had undergone emergency exploratory laparotomy in the Department of General Surgery between the study period of October 2018 and September 2019 were included. Patients were randomly divided into two groups- Group A (Interventional Group) and Group B (control Group). Results: WD occurred in 10 patients (40%) in the intervention group and 12 control patients (48%). There was no significant difference in wound infection between the two groups. Post operative pain based on VAS score on POD was found to be 5 in majority of the patients with mean SF6 88.6 and mean hospital stay of 13.2 days of in the intervention group which was 3, mean SF 36 of 92.3 and hospital stay of 10.6 days in control group. Conclusion: Prophylactic retention sutures reduce the occurrence of WD following midline laparotomy in high-risk patients with multiple risk factors for impaired wound healing.