A Comparative Study of Laparotomy Wounds Closed With Interrupted-X Technique and Conventional Continuous Closures With Vicryl

Sharma, Sanjeev; Sunkaria, B L; Singh, Gagandeep

doi:10.14260/jemds/2017/376

Cited by 3 publications

(7 citation statements)

References 4 publications

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“…Study by Sharma et al, also documented 13 days of mean period of hospital stay. 1 In this study, the mean time taken for rectus closure was 14.07. The difference among both groups is statistically significant (p value of 0.003).…”

Section: Discussionmentioning

confidence: 67%

“…Studies done by Sharma et al (17 minutes); Shashikala et al, (20.5 minutes) with statistically significant results in terms of time taken for rectus closure. 1,10 As the learning curve is steep, initially the interrupted-X technique consumes more time consuming for beginners. Still our study had taken less time as compared to previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…These patients usually undergo multiple dressings, fecal fistula formation, surgery for secondary fascial closure, which is associated with markedly increased morbidity, with high incidence of incisional hernia(up to 45%). 1 developing countries such as India, most patients present with one or more risk factors such as prolonged intraperitoneal sepsis and malnutrition. 2 Dehiscence is associated with increased morbidity and mortality rates up to 30%, prolonged hospital stay, and a long-term risk of developing incisional hernia.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study

et al. 2019

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Background: A major surgical complication after emergency midline laparotomy is abdominal fascial dehiscence. Dehiscence is associated with increased morbidity and mortality rates up to 30%, prolonged hospital stay, and a long-term risk of developing incisional hernia. The risk factors of Wound dehiscence can surgeon factors or patient factors. This study was aimed at comparing effectiveness of interrupted-X technique versus conventional continuous closure of rectus sheath in midline laparotomy in emergency setting.Methods: This study was conducted in a total of 100 patients underwent midline laparotomy for perforation peritonitis in emergency setting. Out of which 50 patients underwent rectus sheath closure by interrupted-X technique (group A) and 50 patients by conventional continuous closure (group B) using non-absorbable, monofilament, no.1 polypropylene suture. Necessary preoperative patient data, wound length, the time taken for rectus closure, length of the suture material used, post-operative complications like wound dehiscence, surgical site infection, period of hospital stay were recorded for analysis.Results: Preoperative patient data among both the groups were comparable. Group A was found to have less wound dehiscence (p=0.001 for partial and p=0.008 for complete) and less period of hospital stay (p=0.054), which were statistically significant. Surgical site infections were similar in both groups. Group B was found to have less time taken for closure (p=0.003) and less length of suture material used (p=0.003), which were statistically significant.Conclusions: Interrupted-X technique of rectus sheath closure reduces the rate of wound dehiscence and period of hospital stay, although it consumes more length of suture material and more time for suturing as compared to conventional continuous closure.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study

et al. 2019

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“…The mean time required for rectus closure was 24.16 minutes, with group A averaging 26.08 minutes and group B averaging 24.24 minutes. Although the difference between the groups was not statistically significant (p-value 0.068), other studies by Sharma et al and Shashikala et al showed statistically significant results regarding the time taken for rectus closure [ 8 , 9 ]. In our study, 34.5% of patients experienced wound dehiscence out of a total of 10 patients.…”

Section: Discussionmentioning

confidence: 81%

Hughes Abdomen Closure Technique Versus Continuous Closure in Emergency Midline Laparotomy: A Randomized Controlled Study

Murthy,

Neogi,

Roy

et al. 2024

Cureus

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Background Abdominal wound dehiscence, a serious postoperative issue, remains a significant concern for surgeons due to its potential to increase patient mortality and morbidity. Disruption can occur at any point after surgery, sparking debate over the optimal closure method for midline vertical abdominal wounds. Therefore, it's crucial to determine the safest approach. Our randomized clinical trial is planned to compare the risk of a burst abdomen associated with the Hughes abdominal closure technique to that of continuous abdominal closure. Methods All patients >18 years scheduled for emergency midline laparotomy were randomly assigned into two groups using computer-generated random numbers: Group A underwent Hughes repair (12 patients) and Group B underwent continuous closure (17 patients). Preoperative data, including patient demographics, and postoperative outcomes, such as time for rectus closure, wound dehiscence, surgical site infection (SSI), and length of hospital stay, were documented for analysis. Results The study found that the average patient age was 37.89 years, with more males than females. Both groups had an equal distribution of co-morbidities (p = 0.468), but none of these factors were statistically significant. Burst abdomen occurred in 25% of group A and 41.1% of group B (p = 0.367, not significant). Incisional hernia was absent in both groups. Surgical site infection (p = 0.119) and respiratory complications (p = 0.16) were not statistically significant between groups. However, in group A, the regressive analysis showed significant associations between burst abdomen, surgical site infection (p = 0.018), and respiratory complications (p = 0.007), while in group B, these associations were not significant (p = 0.252 for SSI and p = 0.906 for respiratory complications). Conclusion The occurrence of burst abdomen and closure time differences between continuous and Hughes techniques were not significant. The Hughes technique was quicker to learn (32 vs. 22 minutes). Burst abdomen was more common in continuous closure (group A: 25% vs. group B: 41%), favoring the Hughes technique. Factors like age, gender, and others didn't significantly impact the burst abdomen in either group.

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“…Later in 2017, Sharma et al compared the complications of two interrupted X-technique and continuous wound closures in patients undergoing midline laparotomy regarding abdominal wound dehiscence (10).…”

Section: Discussionmentioning

confidence: 99%

Comparing Simple Interrupted vs. Continuous Fascial Closure Methods in Elective Midline Laparotomy, a randomized controlled trial

Alamdari

Shams

Hajimirzaie

et al. 2023

Preprint

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Background As a common complication of midline laparotomy, Incisional hernia (IH) imposes an additional cost on the healthcare system. The wound closure method has been considered one of the most critical risk factors for IH.Methods This randomized clinical trial was conducted on elective laparotomy patients between January 2018 and January 2019. All the patients were randomly allocated to two simple interrupted and continuous suture groups. All the surgeries were performed by a single surgeon and used PDS sutures. Demographic information and data on CBC, abdominal ultrasonography reports, and dehiscence or hernia were recorded in a pre-designed checklist. Patients were followed up for one year regarding surgery site pain and infection and the incidence of incisional hernia or fascia dehiscence.Results We analyzed 56 male and 34 female patients with a mean age of 49.53 ± 14.58 in two simple interrupted and continuous suture groups. After a one-year follow-up, 12 (26.6%) patients in simple interrupted and 9(20%) patients in the continuous suture group developed incisional hernia (p = 0.455). In addition, 5 (11.1%) patients in the simple and 3 (6.6%) patients in the continuous suture group had fascial dehiscence (p = 0.459). After the operation, 4(8.8%) patients in the simple and 3 (6.6%) patients in the continuous group developed wound infection (p = 0.694). In addition, there was no significant difference between the two groups on the pain scale following surgery (p = 0.262).Conclusions There are no significant differences between simple interrupted and continuous laparotomy incision closure methods regarding incisional hernia, fascial dehiscence, wound infections, and pain scale.

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A Comparative Study of Laparotomy Wounds Closed With Interrupted-X Technique and Conventional Continuous Closures With Vicryl

Cited by 3 publications

References 4 publications

Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study

Comparison of interrupted-X technique closure versus conventional continuous closure of rectus sheath: a randomized control study

Hughes Abdomen Closure Technique Versus Continuous Closure in Emergency Midline Laparotomy: A Randomized Controlled Study

Comparing Simple Interrupted vs. Continuous Fascial Closure Methods in Elective Midline Laparotomy, a randomized controlled trial

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