Key result
The modified Smead Jones technique significantly reduced the risk of wound infection (RR 0.47) and wound dehiscence (RR 0.23) compared to conventional continuous closure in emergency laparotomy.
Why the study?
Does modified Smead Jones technique reduce wound infection and dehiscence compared to conventional continuous closure in patients undergoing emergency midline laparotomy?
RCT (n=100)
Randomized into two groups
No
Does modified Smead Jones technique reduce wound infection and dehiscence compared to conventional continuous closure in patients undergoing emergency midline laparotomy?
The modified Smead Jones technique is more effective than conventional continuous closure in reducing wound infection and dehiscence following emergency midline laparotomy.
Supports modified Smead Jones closure in emergency laparotomy to cut wound morbidity; extends RCT evidence on technique-specific benefits.
Background: A midline incision is simple, quick, bloodless and provides excellent exposure. So it is most commonly used access route for emergency laparotomy. But compare to other incision it increases incidence of postoperative wound dehiscence and an incisional hernia. Prevention of this complication is important in reducing post-operative morbidity and mortality. Present study was undertaken to compare the effectiveness of modified Smead Jones versus conventional continuous closure technique in terms of wound infection and wound dehiscence.Methods: A total of 100 patients from July 2017 to November 2019 were randomized in two groups of 50 each. Group A in which linea alba closure was done by modified Smead Jones technique and group B in which linea alba closure was done by conventional continuous closure technique.Results: 12 patients in group A and 28 patients in group B developed wound infection and 1 patient in group A and 7 patients in group B developed wound dehiscence.Conclusions: Modified Smead Jones technique is better than conventional continuous closure technique in management of closure of emergency midline laparotomy.
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Aghara et al. (2020) conducted an RCT in Emergency midline laparotomy (n=100). Modified Smead Jones technique vs. Conventional continuous closure technique was evaluated on Wound infection (RR 0.47, 95% CI 0.27-0.75, p=0.001). The modified Smead Jones technique significantly reduced the risk of wound infection (RR 0.47) and wound dehiscence (RR 0.23) compared to conventional continuous closure in emergency laparotomy.
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