Prevention of Burst Abdomen by Interrupted Midline Fascial Closure in Emergency Laparotomy

Background: Burst abdomen represents one of the most frustrating and difficult postoperative complication that concerns every abdominal surgeon. It occurs because of various predisposing factors which can be prevented to some extend by having knowledge regarding them. Despite many years of experience, the optimal technique of emergency laparotomy closure remains more or less controversial. The varieties of surgical excess as well as the varieties of abdominal closure techniques are the main difficulties in the proper standardization of this procedure. Aims and Objectives: The aim of the study was to find out the technique of rectus sheath closure in patients undergoing emergency laparotomy that can reduce the burden of complications in post-operative period. Materials and methods: A total of 260 patients of acute abdominal condition who underwent laparotomy were randomized into two groups of 130 patients in each group. Results: Total 19(7.30%) of 260 patients developed burst abdomen in the post- operative period. Twelve 12(9.23%) in continuous arms and seven 7(5.34%) patients in interrupted arms developed burst abdomen. Burst abdomen occurring mostly 40-60 years of age group with a male to female ratio 1.48:1. Predictor Variables: Cough, anemia, malnutrition, DM, intraperitoneal Sepsis, wound infection, uremia and abdominal distension were the important predisposing factors for the incidence of burst abdomen. Conclusion: Interrupted suturing was associated with significantly reduced the burst abdomen when comparing with continuous closure.