Outcomes of Layered versus Mass Closure in Transverse Incision during Emergency Laparotomy in Children

• 作者: A. K. M. Shahidur Rahman Khandoker Moynul Hasan Md. Ashraf Ul Huq Md. Iqbal Hossain Talukder Mohammad Kamrul Ahsan Mohammad Shafiul Azam Muhammed Moinul Huque Shah Md. Rezaul Karim Shahnoor Islam Sharmin Ara Begum
• 来源期刊: 生物科学与医学(英文)
• 学科: 医学
• 关键词: LAPAROTOMY Layered Closure Mass Closure
• 年，卷（期）: 2020,（8）
• 页码范围: 180-193
• 页数: 14页
• 分类号: R73

摘要

<strong>Background:</strong> The value of laparotomy closure technique may be measured by the incidence of early and late wound complications. The best laparotomy closure technique should be less time consuming, easy and cost-effective, while preventing both early and late complications. <strong>Objective:</strong> To compare the outcomes of layered versus mass closure in transverse incision during emergency laparotomy in children. <strong>Methods: </strong>This prospective comparative study was conducted at Department of Pediatric Surgery, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from July 2016 to June 2018. A total of 60 pediatric age cases that underwent laparotomy were included in this study. Cases were randomly allocated into two groups;30 patients were in Group A (Layered closure) and 30 patients were in Group B (Mass closure). The outcome variables were time required for wound closure, wound infection, wound dehiscence and incisional hernia. Data were analyzed and compared by statistical tests. <strong>Results: </strong>The mean age of Group A and Group B patients were 31.08 ± 30.25 months and 34.70 ± 42.73 months respectively (p = 0.706). The ratio between male and female subject was 1.1:1 in Group A and 3.3:1 in Group B. The common diseases of the study patients who underwent laparotomy were intussusceptions, intestinal obstruction due to bands and adhesion, perforated appendix and perforation of small intestine due to blunt trauma respectively. Mean wound closure time was significantly less in mass closure group [28.20 ± 2.17 minutes in layered closure group and 18.80 ± 1.67 minutes in mass closure group, (p ≤ 0.001)]. Wound infection rate, incidence of superficial wound dehiscence, and incisional hernia were relatively less in mass closure group, however, the differences were not statistically significant (p = 0.053, p = 0.095 and p = 0.301 respectively). There was no complete wound dehiscence in Group A, but that was in 1 (3.3%) patient in Group B (p = 0.313). <strong>Conclusion: