Comparison between mass closure and layered closure in major abdominal laparotomies

ABSTRACT

To compare the. number of complications after continuous layered closure with continuous mass closure in major abdominal laparotomies and to describe the frequency and types of complications after each procedure. From December 2002 to July 2003. The study was conducted in Surgical Unit-I in Nishtar Hospital, Multan. A total 50 patients, 25 in each group. In group-A, 17 [70%] were male and 8 [30%] were female while in group-B there were 16 [64%] male and 9 [36%] female. Age of the patient varied from 13 years to 30 years. In group-A 11 [44%] patients were from elective laparotomies and 14 [56%] from emergencies, while in group-B 8 [32%] patients were from elective operation and 17 [68%] from emergency. In group-A, 6 [24%] had midline incisions while 19 [76%] had paramedian incisions. In group-A clean wound were 12 [48%] and clean contaminated were 13 [52%]. In group-B clean wound were 9 [36%] and clean contaminated were 16 [64%] patients. Group-A had 2 [8%] patients with chest infection and cough in 5 [20%], while in group-B had 1 [4%] patient with chest infection, 2 [8%] with hemorrhage. In group-A small bowel 8 [32%], stomach and duodenum 2 [6%], billiary tract 6 [24%], major abdominal vessels 2 [8%], liver and spleen 1 [4%], colon 3 [12%] and miscellaneous 3 [12%]. In group-B the corresponding figures are small. In group-A wound dehiscence occurred in 2 [8%] patients out of 25 whereas in group-B the dehiscence occurred in none of 25 patients. Using non-absorbable monofilament polyprophylene [prolene] is better than the conventional layered closure with regard to gain of early and late wound strength