Evaluation of Shabir’s SMHS technique of closing dehiscent surgical wounds post-SSIs

Abstract

Objective: Surgical site infection (SSI) is a common problem which often requires the wound to be opened, and the opened infection site needs to be closed back by sutures, once the wound looks okay. Suturing such sites after the infection is under control, by round body needle is difficult and time consuming. Under this background the author has developed an innovative technique for suturing these sites (once infection is under control) by using round bodied needle without any difficulty in circumstances where cutting needles are not easily available Material and Methods: This technique was developed by Dr. Shabir during his residency at Shri Maharaja Hari Singh (SMHS) hospital Srinagar, an associated hospital of Government Medical College, Srinagar (J&K) India, hence also called as Shabir's SMHS technique. This prospective study was undertaken in the Department of Surgery, Government Medical College, Srinagar over a period of 4 years from June 2013 to June 2017. The author compared his technique with suturing by round body needle by conventional method. Patients were divided into two groups 1 and 2, corresponding to Shabir's technique and the conventional round body suturing technique, respectively. Forty patients were taken in each group. Results: Time taken for the procedure was significantly less in Shabir's Technique (P<0.001). Suture material required was significantly less in Shabir's technique (p=0.003). Discomfort / pain experienced by the patients in Group 1 was significantly low (p=0.006) in group 1. Accessory needle injuries were more in group 2 (p<0.001). Conclusion:In developing countries, round body prolene suture can be comfortably used for closing surgical site infection wound, once ready for suturing, when cutting needle suture is not readily available, by applying Shabir's technique without creating additional costs.