Continuous Suture, Dehiscence of Laparotomy Wound, Laparotomy Closure After Abdominal Surgery, Suture, Interrupted, Wound Infection, Surgical
Conditions
Keywords
exploratory laparotomy, Surgical wound infection, Wound dehiscence
Brief summary
The goal of this clinical trial is to learn whether the type of suturing technique used to close the abdomen after exploratory laparotomy affects the rate of wound complications. Specifically, the study aims to find out if using interrupted sutures results in fewer cases of wound dehiscence (wound reopening) compared to continuous sutures. The main question the study seeks to answer is: Does interrupted suturing reduce the frequency of wound dehiscence compared to continuous suturing in patients undergoing exploratory laparotomy? Researchers will also observe and compare wound infection rates between the two suturing methods. About 80 adult patients (18-60 years old) undergoing exploratory laparotomy at the Department of General Surgery, DHQ Teaching Hospital, Dera Ghazi Khan, will take part in this study. Participants will be randomly assigned to one of two groups: Group A: Continuous abdominal closure using No. 1 Vicryl suture Group B: Interrupted abdominal closure using No. 1 Vicryl suture All participants will have their baseline characteristics recorded, including age, gender, obesity, diabetes, and smoking status. The surgical technique and postoperative care will follow the hospital's standard protocols. After surgery, patients will be followed for four weeks with weekly clinical assessments to check for wound infection or wound dehiscence. The hypothesis is that patients whose abdominal wounds are closed with interrupted sutures will have a lower frequency of wound dehiscence compared to those with continuous sutures. The findings will help guide surgeons on which abdominal closure method provides better wound healing and fewer postoperative complications.
Interventions
PROCEDUREContinuous suturing
After an exploratory laparotomy continuous suturing using a single thread of Vicryl No. 1 will be used to stitch the incision's fascial layer together, 1 cm distance from wound edges and between each stitch, creating a line of even tension across the wound.
PROCEDUREInterrupted suturing
After an exploratory laparotomy, interrupted suturing using a single thread of Vicryl No. 1 will be used to stitch the incision's fascial layer together, 1 cm distance from wound edges and between each stitch. A knot will be tied after each suture is passed through the tissue, and each stitch will be secured with its own knot.
Sponsors
Allama Iqbal Teaching Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Undergoing exploratory laparotomy * Both emergency and elective
Exclusion criteria
* Patients undergoing second laparotomy or re- laparotomy * Patients on steroid therapy (assessed on medical record review) * Patients who die within 28-days of surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wound Dehiscence | From enrollment to 28-days of operation | A partial or total separation of previously approximated wound edges, on clinical examination of surgical wound. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Surgical Wound Infection | From enrollment to 28-days after operation | Presence any features of erythema, pain, pus discharge on examination of surgical wound and new onset fever (\> 98.60F) |
Countries
Pakistan
Outcome results
None listed