Muthanna Al-jumaili
Department of Surgery, Hospital of Southern Jutland, Aabenraa, Denmark
| Project management | ||
| Project status | Open | |
| Data collection dates | ||
| Start | 25.08.2023 | |
| End | 28.02.2025 | |
Interrupted Z versus continuous suture for closure of fascia after midline laparotomy in the prevention of wound dehiscence
Short summary
Abdominal wound dehiscence or burst abdomen is a serious post operative complication. One of the important factors that affect the incidence of wound dehiscence is the closure technique. Closure of fascia after midline laparotomy using many interrupted Z-shaped sutures is relatively new method that have been used in a single surgical department through many years, but there is no statistical evidence that this method can prevent abdominal wound dehiscence.
Rationale
Abdominal wound dehiscence or burst abdomen is one of the most serious post operative complications. It is associated with higher risk of mortality and morbidity, with a mortality rate up to 30-35% (1-3). It leads also to prolonged hospital stay, and incredibly increases the long-term risk of developing incisional hernia (1,3). The incidence of wound dehiscence after midline laparotomy is still high and is reported up to 5% in elective surgery and a higher in the emergency setting (1-4). One of the important factors that affect the incidence of wound dehiscence is the closure technique (3). There have been many studies evaluating various fascia closure methods such as running suture, single interrupted suture(5-7), Hughes repair(8,9), interrupted x(8), smead-jones suture and the use of retain suture or prophylactic mesh(2,10,11), and their effect on the prevention of post operative complications. Closure of fascia after midline laparotomy with interrupted Z-shaped suture is a method that used by many surgeons in one surgical department in Denmark through many years, but there is no statistical evidence that can support the efficacy of this new method over the conventional continuous closure method in the prevention of post operative complications. The aim of this study is to investigate whether the facia closure with interrupted Z-shaped sutures is superior to the conventional closure method in prevention of post operative wound dehiscence.
Description of the cohort
All patients who underwent midline laparotomy from January 2015 through December 2022 were retrospectively reviewed primarily for facial closure technique. Z-shaped closure technique was compared with conventional running suture in abdominal fascial closure. During 30 days post-operative follow op period, abdominal wound dehiscence was the primary outcome
Collaborating researchers and departments
Department of Surgery, Aabenraa Hospital