Results of the Smead-Jones technique of closure of vertical midline incisions for emergency laparotomies--a prospective study of 403 patients.

ABSTRACT

The early and late results of the Smead-Jones (SJ) technique of closure of emergency vertical midline laparotomies was compared with other conventional methods of closure such as anatomical repair (AR), mass closure (MC) and single layer (SL) closure. Four Hundred and Three patients who underwent emergency laparotomy were studied prospectively. The results of SJ closure of laparotomy in them were compared with other techniques of abdominal closure. Ninety percent of patients with SJ were in wound class IV and at high risk of wound complications. It was seen that the overall infection rate for SJ at 12.4% was significantly less than all other types of closure. The wound dehiscence rate for SJ at 3.0% was the lowest. This protective effect of SJ against dehiscence was also seen in the presence of post operative chest infection and abdominal distension. The incisional hernia rate for SJ was also lowest (4%). The appearance of the scar was comparable to the other techniques of follow up. The present study concluded that the Smead-Jones techniques of laparotomy closure had very low incidence of early and late complications and was superior to other conventional methods of closure.