Layered closure versus mass closure a study of 50 cases at Nishtar hospital, Multan

ABSTRACT

A comparative study of 50 cases to compare the number of complications after layered closure with mass closure in major abdominal operation conducted in surgical Unit-II, Nishtar Hospital, Multan extending over a period of 3 years from January 2000 to January 2003. In group-A 17 [70%] were male and 8 [30%] were female. In group-B 16 [64%] were male and 9 [36%] were female. Age of the patients 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%] were from elective operation and 17 [68%] from emergency. In group-A 6 [24%] had midline incision while 19 [76%] had paramedian incision. In grup-A clean wound wee 12 [48%] and clean contaminated were 13 [52%]. In group-B clean wounds 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%] patients with chest infection, 2 [8%] with hemorrhage. In group-A small bowel 8 [32%], stomach and duodenum 2 [8%], biliary tract 6 [245], 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