Prevention of Burst Abdomen by Interrupted Closure: A Comparative Study of Conventional Continuous Versus Modified Smead-Jones Far-And-Near Interrupted Abdominal Fascial Closure in Surgical Patients

Abstract

Introduction: Abdominal wound dehiscence or burst abdomen is disruption of any or all off the layers in a wound. Abdominal wound dehiscence is a common complication of emergency laparotomy in cases of perforation peritonitis in Indian setup.

Aims: To estimate and compare the incidence of Abdominal Wound Dehiscence or Burst Abdomen among Continuous closure and Modified Smead-Jones Far-and-Near interrupted type abdominal fascial closure.

Materials and method: The present study was a comparative study. This Study was conducted from 8 months at the Institute of General Surgery, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai. Total 114 patients were included in this study.

Result: In Conventional Continuous, 32 (56.1%) patients had incidence of burst abdomen. In Modified Smead Jones, 22 (38.6%) patients had incidence. Association of Incidence with Group was not statistically significant (p=0.0606). In Conventional Continuous, the mean Hypoproteinenmia of patients was 3.1579 ± 2.4333. In Modified Smead Jones, the mean Hypoproteinenmia (mean ±s.d.) of patients was 3.5965 ±2.2667. Distribution of mean Hypoproteinenmia with treatment was not statistically significant (p=0.3215). In Conventional Continuous, the mean Uremia of patients was 2.5965 ± 1.9259. In Modified Smead Jones, the mean Uremia of patients was 2.2456 ±2.0025. Distribution of mean Uremia with Treatment was not statistically significant (p=0.3424).

Conclusion: The far-and-near interrupted closure technique may offer superior strength and support to the abdominal fascia, thereby reducing the risk of postoperative complications such as wound dehiscence.