Does a specific abdominal closure technique reduce the incidence of burst abdomen in patients undergoing emergency laparotomy?
A specific abdominal closure technique resulted in a low rate of burst abdomen (2.38%) in patients undergoing emergency laparotomy for generalized peritonitis.
Background: Abdominal wound closure technique should be efficient to perform, provide strength and be a barrier to infection. The method of closure of the abdominal wall is a critical aspect of an effective incision closure, in addition to the choice of suture material. Abdominal wound dehiscence is a common complication of emergency laparotomy. This study was done to know whether our method of abdominal closure was helpful in reducing incidence of burst abdomen.Methods: This retrospective study was carried out in the department of general surgery in a tertiary medical centre in Mumbai. 126 Patients undergoing emergency laparotomies for extensive generalised peritonitis through a vertical midline incision were included in this study; the indications for laparotomy were inflammatory, traumatic and neoplastic.Results: Out of 126 patients undergoing closure of laparotomy wound by our method, wound infection was noted in 12 (9.52%) cases and 3 (2.38%) patients developed wound dehiscence (burst abdomen).Conclusions: This retrospective study demonstrates that our method of abdominal closure was helpful in reducing the incidence of burst abdomen post-operatively. This is of extreme clinical importance in reducing morbidity, mortality and healthcare cost related to abdominal wound dehiscence in a patient undergoing emergency laparotomy.
Gandhi et al. (2016) studied this question.