COMPARING THE EFFICACY OF MODIFIED CONTINUOUSSMEAD-JONES VERSUS CONVENTIONAL CLOSURE OFMIDLINE LAPAROTOMYWOUND

Background: Disruption of abdominal incision is a serious event. Various methods have been employed in abdominal surgeries to close the abdominal wall. Abdominal wound dehiscence is a common complication of emergency laparotomy. There is an increase in the cost and hospital stays. Prevention of this complication is important inreducing post-operative morbidity and mortality.

Objectives: The study was carried out in the Department of General Surgery, MMC&RI, Mysuru.

1. To evaluate effectiveness of modified continuous Smead-Jones Technique.

2. To compare effectiveness of modified continuous Smead-Jones with conventional technique of abdomen wound closure on the basis of incidence of wound dehiscence.

Methods: The study was carried out on a total of 110 patients who were randomized in two groups of 55 each. 55 patients underwent closure of mid line laparotomy wound using modified continuous Smead-Jones technique (study group) and 55 patients underwent closure by conventional method (control group).

Results: The mean age group was 46 to 49. Male patients were more common compared to female. Out of the various causes of acute abdomen, Prepyloric perforation was the most common cause, followed by duodenal perforation. Out of 11 cases who had wound dehiscence, most of them were for Pre pyloric perforation (55%), second most common was ileal perforation (27%). Patients with risk factors had higher incidence of wound infection and wound dehiscence. Out of 110 patients, 32(29.1%) had wound infection, 12(21.8%) in the study group and 20(36.3%) in the control group. A total of 11(10%) patients had wound dehiscence, only 2 (3.6%) patients in the study group, whereas 9 (16.3%) in the control group.

Interpretation and conclusion: Modified Smead-Jones technique decreases the incidence of wound dehiscence and can be used to close the midline laparotomy wound in cases requiring emergency midline laparotomy.