Interrupted Braided Sutures versus Running Monofilament Sutures in the Prevention of Abdominal Wound Dehiscence : A Prospective Nonrandomized Case-Control Trial

Abstract

Objective: To compare the impact of interrupted braided suture to continuous monofilament sutures on the development of abdominal wound dehiscence in high risk patients. Methods: Clinical judgment and the Rotterdam risk score of abdominal wound dehiscence were used to identify 140 patients at high risk for abdominal wound dehiscence. Seventy high-risk patients who had their laparotomy wounds closed by interrupted braided suture (intervention group) were compared to a similar group of patients who had continuous monofilament suture closure (control group). Demographic, clinical and operative data of both groups were compared. The primary outcome was the occurrence of wound dehiscence either partial or complete. Secondary outcomes include development of wound infection and the 30-day mortality rate. The mean follow up period was 3 months (range 1-6 months). Results: There were 78 males and 62 females with a mean age of 62.2±13.0 years. Both groups were equivalent in terms of demographics, Rotterdam risk score, type of surgery and surgical incision. Wound dehiscence occurred equally in both groups (24.3 in control vs 22.9% in intervention group, p value 0.842) but evisceration was significantly reduced by the use of interrupted sutures (4.3 vs 14.3%, p value 0.042). The method of closure has no significant impact on infection and early mortality. Conclusion: Although method of closure did not affect the overall incidence of wound dehiscence, interrupted braided sutures significantly reduced occurrence of evisceration. This reduced the need for urgent revisional surgery but did not affect the early mortality rate. A larger randomized control trial with a longer follow up period is advised.

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

“…Surgical site infection was observed in 58.6% of patients in this study, with no significant difference between the groups (p-value 0.367). Studies by Kumar et al and Al-Faouri et al did not find any statistical significance among groups [ 10 , 13 ]. However, studies by Agrawal et al and Dhamnaskar et al were statistically significant [ 14 , 15 ].…”

“…al. and Al-Faouri et al did not find any statistical significance among groups[10,13]. However, studies by Agrawal et al and Dhamnaskar et al were statistically significant[14,15].…”

Comparison of outcome of interrupted versus continuous closure technique of rectus sheath in emergency laparotomies patients in terms of wound dehiscence.

“…5 Evaluation and possible correction of these factors is very essential in prevention of dehiscence. 6 According to another study, excessive tension should be avoided during closure. 7 Patients with generalized peritonitis and malignancy need special attention regarding wound closure.…”