Prophylactic Retention Sutures in Midline Laparotomy in High Risk Cases to Prevent Wound Dehiscence

Introduction: Abdominal Wound Dehiscence is acommon post-operative complication with high morbidity and mortality. Several risk factors for the occurrence of dehiscence have been described. Retention sutures are often used in surgical take-back for dehiscence. Methods: 50 patients who underwent midline laparotomy for various causes with 2 or more of the risk factors for dehiscence were randomised into two groups of 25 each. The study group in which laparotomy wound was closed with conventional mass closure along with full thickness retention sutures and a control group in which mass closure alone was done. Result: The incidence of wound dehiscence in the study group was reduced. There was only 1 case of dehiscence in the study group compared to 5 in the control group. All 5 cases of WD in the control group underwent re-laparotomy and fascial closure. There was no significant difference in the post-operative pain and duration of hospital stay in both the groups. Conclusion: The study concludes that, prophylactic retention sutures could reduce the incidence of wound dehiscence in midline laparotomy in cases with multiple risk factors without imposing remarkable post-operative complications.