Surgical workshop avoiding operative wound sepsis by a new subcutaneous suturing technique

ABSTRACT

Postoperative wound infection adds considerably to the morbidity and mortality of patients and increases the length of hospitalization and medical costs [Green and Wenzel, 1977]. Bacterial contamination of the operative wound may be exogenous or endogenous and usually is confined to the subcutaneous tissues. Despite every effort to maintain asepsis, we can not guarantee against microscopical contamination [Pollock, 1985]. It is crucial, therefore that the presence of sutures in the subcutaneous layer particularly when there has been contamination following open viscus surgery will predispose to wound complications such as suture abscesses, granulomas and sinuses [Carlos, 1983]. Moreover bacterial migration along braided sutures, reactivity of some absorbable sutures and strangulating effect of tight sutures add to the risk of wound sepsis [Staffer et al., 1986]. Together with subcuticular suture for skin closure, the author has for a number of years adopted a new technique for subcutaneous tissue approximation that allows sound wound healing with minimal scarring and almost avoiding wound sepsis