Modified Technique for Closure of Midline Abdominal Incisions

Abstract

Background: Surgical minds are still in the search for ideal method of closure of laparotomy incision. Nonabsorable sutures have decreased the incidence of dehiscence and incisional hernia but cause suture sinuses, painful suture knots and button-hole defects. The present study describes a modified technique with polypropylene and evaluates its complication rate. Methods: This study is prospective analysis of 140 patients having undergone closure of midline laparotomy incisions using this technique during the period January 1999- December 2003. All the patients were followed for 12 months. Principle outcome measures were post- operative complications of dehiscence, incisional hernia, infection, suture sinuses, button-hole defects and pain at wound. Results: Post-operative complications encountered included 12 patients with wound infection, 2 with dehiscence and 1 with incisional hernia. No patient reported with suture sinus, button-hole defect or chronic painful wound. 89.28% (125) patients studied had satisfactory repair with no complications. Conclusions: The technique described here provides a safe repair using non absorbable suture with low complication rate. This technique may be used with absorbable sutures.