Advertisement

Indian Journal of Surgery

, Volume 80, Issue 6, pp 564–568 | Cite as

Prophylactic Retention Sutures in Midline Laparotomy in High-Risk Patients for Wound Dehiscence: a Randomised Prospective Case Control Study

  • Ajay Maganlal RajyaguruEmail author
  • Milap Jignesh Shah
  • Bhavesh V. Vaishnani
  • Jignesh P. Dave
  • Jatin G. Bhatt
Original Article
  • 115 Downloads

Abstract

Abdominal wound dehiscence (AWD) is one of the most notorious complication after laparotomy and associated with high morbidity and mortality. The retention suture is used in the re-operated cases of wound dehiscence to reduce the disruption of fascia. To study the effect of prophylactic retention sutures in patients with high risk for wound dehiscence who underwent midline laparotomy. Random selection of 200 midline laparotomy cases was done divided into two groups. In the one group (Cases- group A) Conventional mass closure of midline fascial wound closure with incorporation of prophylactic retention sutures. In other group (Control group - group B) midline line fascial closure by conventional mass closure without incorporation of prophylactic retention sutures. Comparison of both the techniques regarding preoperative status and postoperative complication such as incisional hernia, wound dehiscence and chronic wound pain was done according to clinical examination and recorded in the pro forma prepared. Incorporation of prophylactic retention sutures reduce the occurrence of WD following midline laparotomy in high-risk patients with multiple risk factors for impaired wound healing without imposing remarkable post-operative complications.

Keywords

Wound dehiscence High-risk patients Retention sutures Prophylaxis 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declared that they have no conflict of interest.

References

  1. 1.
    Riou JP, Cohen JR, Johnson H Sr (1992) Factors influencing wound dehiscence. Am J Surg 16(3):324–328CrossRefGoogle Scholar
  2. 2.
    Zhamak et al (2012) Prophylactic retention sutures in midline laparotomy in high risk cases of wound dehiscence: a randomized controlled trial. Assoc Acad Surg 178(11):110–115Google Scholar
  3. 3.
    Armstrong CP, Dixon JM, Duffy SW et al (1984) Wound healing in obstructive jaundice. Br J Surg 71(6):267CrossRefGoogle Scholar
  4. 4.
    Gialson H, Gronbech JE (1995) Burst abdomen and incisional hernia after major gastrointestinal operations and comparison of closure techniques. Br J Surg 51(4):154–159Google Scholar
  5. 5.
    Macdougal BA (1995) Locking a continuous running suture. J Am Coll Surg 18(1):563Google Scholar
  6. 6.
    Medical Dictionary for the Health Professions and Nursing © Farlex 2012Google Scholar
  7. 7.
    Spiliotis J, Tsiveriotis K, Datsis AD, Vaxevanidou A, Zacharis G et al (2009) Wound dehiscence is still a problem in the 21th century: a retrospective study. World J Emerg Surg 4:12.  https://doi.org/10.1186/1749-7922-4-12 CrossRefGoogle Scholar
  8. 8.
    O’Dwyer PJ, Courtrey CA (2003) Educational review: Factors involved in abdominal wall closure and subsequent incisional hernia. Surgeon 1(1):17–22Google Scholar
  9. 9.
    Adams G, Richter RM (1973) A safe method of closure with retention sutures. Ann Surg 13(6):98–100Google Scholar
  10. 10.
    Banerjee SR, Daoud, Russeell JC et al (1983) Abdominal wound evisceration. Ann Surg 40(3):432–436Google Scholar
  11. 11.
    Miles RM, Nash JP et al (1967) Value of retention sutures in the prevention of experimental abdominal wound disruption. Am J Surg 33(12):898–905Google Scholar
  12. 12.
    Mohanad et al (2013) Effect of retention sutures in prevention of abdominal wound dehiscence. Assoc Acad Surg 152(1):223–229Google Scholar
  13. 13.
    Pennickx et al (1979) Abdominal wound dehiscence in gastroenterological surgery. Ann Surg 189:345CrossRefGoogle Scholar
  14. 14.
    Hubbard, Rever et al (1982) Determinants of wound dehiscence in abdominal surgery. Am J Surg 26(10):698–705Google Scholar
  15. 15.
    Rink AD, Goldschmidt D, Dietrich J et al (2000) Negative side effects of retention sutures for abdominal wound closure. A prospective randomised study. Eur J Surg 166:932–937Google Scholar

Copyright information

© Association of Surgeons of India 2017

Authors and Affiliations

  • Ajay Maganlal Rajyaguru
    • 1
    • 2
    Email author
  • Milap Jignesh Shah
    • 1
  • Bhavesh V. Vaishnani
    • 1
  • Jignesh P. Dave
    • 1
  • Jatin G. Bhatt
    • 1
  1. 1.Department of SurgeryRajkotIndia
  2. 2.“Sanjay”RajkotIndia

Personalised recommendations