COMPARISON OF WOUND DEHISCENCE IN CASES OF LAPAROTOMY CLOSED BY CONTINUOUS AND INTERRUPTED TECHNIQUE

Authors

  • ZU ISLAM Department of General Surgery, Saidu Group of Teaching Hospital, Swat, Pakistan
  • M HUSSAIN Department of General Surgery, Saidu Group of Teaching Hospital, Swat, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.155

Keywords:

Wound Dehiscence; Laparotomy; Continuous Suture; Interrupted Suture; Emergency Surgery; Randomized Controlled Trial

Abstract

Background: Wound dehiscence is a serious postoperative complication following emergency laparotomy, associated with high morbidity and mortality. The choice of abdominal wall closure technique — continuous or interrupted — plays a key role in preventing this complication. Objective: To compare the frequency of wound dehiscence in cases of laparotomy closed by continuous versus interrupted techniques. Study Design: randomized controlled trial. Setting: The department of surgery, Saidu Sharif Medical College, Swat, Pakistan. Duration of Study: 10-01-2024 to 10-07-2024. Methods: A total of 184 patients undergoing emergency laparotomy were included and divided into two equal groups. Group A (n = 92) underwent closure with a continuous technique, while Group B (n = 92) underwent closure with an interrupted technique. Wound dehiscence was defined as the disruption of abdominal wall layers with serosanguinous discharge or evisceration within 15 postoperative days. Data were analyzed using SPSS, with a p-value <0.05 considered significant. Results: The mean age was 45.24 ± 16.02 years in Group A and 46.95 ± 15.43 years in Group B. In Group A, 57 (62.0%) were males and 35 (38.0%) females, while Group B included 54 (58.7%) males and 38 (41.3%) females. Wound dehiscence occurred significantly more frequently in the continuous group (16 patients, 17.4%) compared to the interrupted group (6 patients, 6.5%) (p < 0.05). Conclusion: The interrupted technique of laparotomy closure was associated with a significantly lower frequency of wound dehiscence compared to the continuous technique, suggesting it may be a safer option in emergency laparotomy cases.

References

Ahsan A, Haque MF, Islam MR. Risk factors and operative findings of abdominal wound dehiscence in emergency laparotomy. Saudi J Med Pharm Sci. 2022;8(8):430–5. https://doi.org/10.36348/sjmps.2022.v08i08.010

Gillespie BM, Harbeck EL, Sandy-Hodgetts K, Rattray M, Thalib L, Patel B, et al. Incidence of wound dehiscence in patients undergoing laparoscopy or laparotomy: a systematic review and meta-analysis. J Wound Care. 2023;32(Suppl 8a):S31–43. https://doi.org/10.12968/jowc.2023.32.Sup8a.S31

Nirenjen S, Narayanan J, Tamilanban T, Subramaniyan V, Chitra V, Fuloria NK, et al. Exploring the contribution of pro-inflammatory cytokines to impaired wound healing in diabetes. Front Immunol. 2023;14:1216321. https://doi.org/10.3389/fimmu.2023.1216321

Takahashi M, Umehara Y, Yue H, Trujillo-Paez JV, Peng G, Nguyen HL, et al. The antimicrobial peptide human β-defensin-3 accelerates wound healing by promoting angiogenesis, cell migration, and proliferation through the FGFR/JAK2/STAT3 signaling pathway. Front Immunol. 2021;12:712781. https://doi.org/10.3389/fimmu.2021.712781

Howle R, Ng SC, Wong HY, Onwochei D, Desai N. Comparison of analgesic modalities for patients undergoing midline laparotomy: a systematic review and network meta-analysis. Can J Anesth. 2022;69(1):140–76. https://doi.org/10.1007/s12630-021-02128-6

McGeehan G, Edelduok IM, Bucholc M, Watson A, Bodnar Z, Johnston A, et al. Systematic review and meta-analysis of wound bundles in emergency midline laparotomy identifies that it is time for improvement. Life (Basel). 2021;11(2):138. https://doi.org/10.3390/life11020138

Shah RP, Sah LL, Pandit RK. Comparing clinical outcomes between patients receiving non-absorbable and delayed absorbable sutures for abdominal wound closure after laparotomy. Int Surg J. 2023;10:1284–8. https://doi.org/10.18203/2349-2902.isj20232321

Sheik-Ali S, Guets W. Absorbable vs non-absorbable sutures for wound closure: systematic review of systematic reviews. Wound Med. 2018;23:35–7. https://doi.org/10.1016/j.wndm.2018.09.004

Dragovic M, Pejovic M, Stepic J, Colic S, Dozic B, Dragovic S, et al. Comparison of four different suture materials in respect to oral wound healing, microbial colonization, tissue reaction and clinical features—randomized clinical study. Clin Oral Investig. 2020;24:1527–39. https://doi.org/10.1007/s00784-019-03034-4

Eickhoff R, Eickhoff SB, Katurman S, Klink CD, Heise D, Kroh A, et al. Influence of suture technique on anastomotic leakage rate: a retrospective analyses comparing interrupted versus continuous sutures. Int J Colorectal Dis. 2019;34(1):55–61. https://doi.org/10.1007/s00384-018-3168-6

Zabd AR, Naveed M, Javeed MU, Akbar A. Comparison of wound dehiscence in interrupted with continuous closure of laparotomy. Pak J Med Health Sci. 2013;7(3):826–9.

Ramalingam M, Kallappan S, Nachimuthu S. A prospective comparative study of continuous and interrupted suturing in laparoscopic pyeloplasty in 3D era. J Laparoendosc Adv Surg Tech. 2018;28(11):1275–8. https://doi.org/10.1089/lap.2018.0203

Tahir A, Sajid M, Ansari MSH, Khan AW. Wound dehiscence: comparison of continuous and interrupted closure of wound dehiscence in emergency midline laparotomy incision. Professional Med J. 2018;25(8):1143–6. https://doi.org/10.29309/TPMJ/2018.25.08.59

Akbar F, Khan M, Ahmad N, Abbas S, Khan N. Comparison of laparotomy wound dehiscence rate using continuous suture technique with interrupted X-suture technique. J Saidu Med Coll Swat. 2021;11(3):134–6. https://doi.org/10.52206/jsmc.2021.11.3.646

Nasir M, Siddique M, Zaeem A, Raza A, Rizwan M, Abbas M. Comparison of continuous versus simple interrupted polypropylene suture closure of midline emergency laparotomy wound in terms of wound outcome in adult patients presenting with acute abdomen. Pak J Health Sci. 2025;6(1):283–8. https://doi.org/10.54393/pjhs.v6i1.2634

Polychronidis G, Rahbari NN, Bruckner T, Sander A, Sommer F, Usta S, et al. Continuous versus interrupted abdominal wall closure after emergency midline laparotomy: CONTINT randomized controlled trial [NCT00544583]. World J Emerg Surg. 2023;18(1):51. https://doi.org/10.1186/s13017-023-00517-4

Syed WH, Ahmed R, Qureshi U, Khan JS, Shafique S, Azhar F, et al. Exploratory laparotomies in the emergency room: increasing burden and implications in Pakistan. Rawal Med J. 2020;45(4):798–801.

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Published

2025-09-20

How to Cite

ISLAM , Z., & HUSSAIN , M. (2025). COMPARISON OF WOUND DEHISCENCE IN CASES OF LAPAROTOMY CLOSED BY CONTINUOUS AND INTERRUPTED TECHNIQUE. Pakistan Journal of Intensive Care Medicine, 5(02). https://doi.org/10.54112/pjicm.v5i02.155

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Original Research Articles