Comparative Study of Continuous Versus Interrupted X-Type Abdominal Fascial Closure in Reference to Burst Abdomen

Background: Abdominal wound dehiscence is a common complication of emergency laparotomy in Indian setup. Its prevention is important in reducing post-operative morbidity and mortality. The search for the optimal laparotomy technique has gone on for more than 100 years and will continue. Aims and Objective: The aim was to compare the risk of burst abdomen with continuous versus interrupted suturing in midline laparotomy in emergency setting. Patients and Methods: This was single arm open randomized trial. The data were collected at surgical wards of Rajendra Institute of Medical Sciences Hospital, Ranchi. 110 patients undergoing emergency laparotomy through midline vertical incisions were randomized after informed consent by either continuous closure or by interrupted X technique. The major outcome variable is risk of burst abdomen diagnosed by a consultant. The risk of burst in each group and relative risk (RR) of burst (using continuous group as the reference category) were assessed. Result: There were three bursts (out of 53) in X type interrupted suture group and 12 bursts (out of 57) continuous suture group. The RR of burst (continuous group as reference category) was 1.195 (95% confi dence interval; 1.029-1.387, P = 0.0195).