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SUBCUTICULAR WITH INTERRUPTED SUTURING; TECHNIQUE FOR ABDOMINAL WOUND CLOSURE

Authors: Mazin H AL-Hawaz --- , Mushtaq CH Abu-alhail --- Sabah S Jabir
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2010 Volume: 16 Issue: 2 Pages: 55-61
Publisher: Basrah University جامعة البصرة

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Abstract

Closure of the wound after surgery is a routine procedure and one of the first things that asurgeon in training should learn. A surgeon will successfully closes a thousand of woundsduring his career, but the problem of wound infection remains challenging.This study was conducted to compare between two methods of skin closure which aresubcuticular alone and combined subcuticular with interrupted suturing regarding; woundinfection, cosmesis &speed of wound closure.Between December 2006 and October 2009, two hundred and two patients were admitted inBasrah General Hospital, department of surgery. They underwent elective abdominal operationand were randomized into two groups, group A (abdominal skin closure by subcuticular suturingonly) and group B (combined subcuticular with interrupted suturing). There were 102 cases inthe subcuticular group, 50 cases of them were males and 52 cases were females, while ingroup B there were 100 cases,42 cases of them were males and 58 cases were females. Meanage was 38.9 (range 4-66) for group A and 41.6 (range 8-67) for group B. The mean BMI was25.2 (range 17.4-34.8) for group A and 26.4 (range 18.7-39) for group B.Results: Wound infection: The total number of early wound infection for the six �weeks follow �up period was 12 cases (11.7%) for the subcuticular (group A),and 4 cases (4%) for thecombined (group B)_(P=0.036). Cosmoses: There was no significant difference in cosmeticresult in both groups. Speed of wound closure: Combined (group B) closure was accomplishedat significantly faster rate (mean 35.6 sec/cm) than subcuticular (group A) closure (mean46.8sec/cm) (p=0.001). Conclusion: From this study we conclude that the choice of techniquefor wound closure did not affect the final cosmetic outcome of the wound but the incidence ofpostoperative wound infection significantly reduced by combined subcuticular and interruptedsuturing. The closure of wound is rapid in combined group than in subcuticular group alone.

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