Background: There are no accepted guidelines for the closure of laparotomy incisions inpatients of peritonitis. As these patients differ from the patients undergoing electiveabdominal surgery, the same recommendations for closure may not be applicable in bothgroups.
Aim: To compare wound outcome parameters following closure of the laparotomy incisionwith absorbable and non-absorbable suture material using the continuous and interruptedtechniques in patients of peritonitis.
Method: A single blinded randomised controlled trial using Polygalactin–910 andPolypropylene, number 1 sutures, to close midline vertical incisions, placed in continuousand interrupted manner, was performed on 174 patients. Patients were randomised intofour groups: Group A (Polygalactin-910 continuous suturing, n=40), B (Polygalactin-910interrupted suturing, n=47), C (Polypropylene continuous suturing, n=45) and D(Polypropylene interrupted suturing, n=42). The incidence of wound infection, dehiscence,suture sinus formation and incisional hernia was recorded. Patients were followed up fora period of four years. Statistical analysis involved the chi-square and Fisher’s exact tests.A ‘p’ value of <0.05 was considered significant.
Results: The study included 139 male and 35 female patients between the ages of 10 and75 years. The incidence of wound infection (p=0.656), dehiscence (p=0.997), and incisionalhernia (p=0.930) at 3 months and four years (p= 0.910) was not statistically significant.There was no sinus formation in groups A and B, however 2 patients of group C and 6patients of group D did develop suture sinus (p=0.003).
Conclusion: Suture material and technique of closure does not influence wound outcomein patients of peritonitis except for a significantly lower incidence of sinus formation whennon-absorbable sutures are used.