Comparison between conventional and modified Smead Jones method for abdominal mass closure in emergency midline laparotomy

Document Type : Original Article

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General Surgery Department Faculty of Medicine, Sohag University, Sohag, Egypt

Abstract

Background:  The way the abdomen was closed and the sutures that were employed may have an impact on wound dehiscence. To increase the benefits, we suggested changing the original Smead-Jones technique to be performed continuously. We discovered that this method was quicker, more affordable, equally effective at controlling wound infection, and better than interrupted technique at preventing wound dehiscence. The purpose of the study was to evaluate the Modified Smead Jones technique's efficacy in emergency midline laparotomies compared to the traditional continuous closure technique, as well as the incidence of wound dehiscence in each technique. Methods: Patients in this randomized clinical study who received an emergency laparotomy through a midline incision were included. Cases were then divided into: Group A: Linea alba was closed with Modified Smead Jones    technique using a polypropylene 1 number with Far-near near-far technique. Group B: Linea alba was closed with conventional continuous technique using a polypropylene 1 number. Preoperative data, operative data, intra operative complications, early postoperative follow up and complications were recorded. Results: Pre-duodenal perforation, traumatic jejunal/ileal, colon, appendicular, ileal stricture/band, intestinal blockage, and intussusception were insignificantly different among the laparotomy indications between the two groups. Wound dehiscence was insignificantly different between both groups. Group A had a much shorter hospital stay than group B (P value <0.001).Conclusions: An emergency laparotomy necessitates careful attention to wound closure. When it comes to managing midline laparotomy closure, the modified Smead Jones technique outperforms the traditional continuous technique in terms of wound dehiscence and hospital stay.

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