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Comparison between continuous vs. interrupted x-suture for midline laparotomy wound closure

Mayank Badkur*, Satta ram, Seema Patel, Anil Gupta

Introduction: Midline laparotomy incision for emergency or elective surgery allows satisfactory and quick exposure to all quadrants. Wound dehiscence, burst abdomen and incisional hernia are some of the common postoperative complications. Apart from patient’s factor suture material and method of closure are main factor related to these complications. This study compares the continuous sutures and interrupted x-type sutures in mass closure of midline laparotomy wound.

Materials and method: Comparative prospective hospital based study was conducted in a tertiary health centre of west India for 12 months after ethical approval and obtaining informed written consent. In control group continuous closure was performed, and in study group Interrupted closure was done to close the midline laparotomy incision. Early complications were noted and after discharge patients were followed up at 15 days, 3 months, 6 months and 1 year interval. Data was collected in a pre-structured pre-tested Performa. Analysis was done using Microsoft excel and statistical software SPSS.

Results: Total 120 patients participated in the study. Contamination of incision site was not statistically significant in both the groups. The hospital stay of almost 10 days was also similar in both groups. There was no significant difference in incidence if wound infection. Occurrence of wound dehiscence and incisional hernia was significantly higher in continuous suture group as compared to interrupted X suture group.

Conclusion: Interrupted X suture prevented the occurrence of wound dehiscence and incisional hernia significantly as compared to continuous suture in our study. A larger randomized control trial with a longer follow up period is needed.

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