COMPARISON OF THE EFFECTIVENESS OF CONTINUOUS VERSUS INTERRUPTED CLOSURE OF MIDLINE WOUND IN EMERGENCY LAPAROTOMIES IN TERMS OF WOUND DEHISCENCE

ABSTRACT
A major surgical complication after laparotomy is dehiscence of the abdominal fascia, which may appear either
as an early (burst abdomen with evisceration) or a late (incisional hernia) complication. These patients usually undergo
surgery for secondary fascial closure, which is associated with markedly increased morbidity.
Objective: To compare the effectiveness of continuous versus interrupted closure of midline wound in emergency
laparotomies in terms of wound dehiscence.
Methodology: This was a randomized controlled trial conducted in Khyber Teaching Hospital from February 1st, 2016
to January 31st, 2016. Sampling technique was non probability consecutive sampling. Total sample size was 180 (90
patients in each group). Wound dehiscence occurred in 4.55% of laparotomy patients in modified technique compared
to 15.70% of laparotomy patients in continuous technique, with 5% level of significance and 80% power of test with
the help of WHO formula.
Results: A total of 180 patients of emergency laparotomies were observed, which were divided in two equal groups.
Overall Male to female ratio was 1.54:1. The overall average age of the patients was 39.41 years +13.02SD. Effectiveness
wise distribution shows that Group A was effective in 85(94.4%) patients while Group B shows effectiveness in
77(85.6%) patients which shows that effectiveness was significant in both the group with p-value=0.04.
Conclusion: Interrupted closure of midline wound in emergency laparotomies is more effective than continuous closure