A Prospective and Retrospective Comparative Study of Free Omental Sheet Graft and Other Operative Procedures of Enteric Perforation Repair

Background: Enteric perforation, often caused by infectious diseases like typhoid, is a significant cause of morbidity and mortality in developing countries such as India. Our study aims to compare the outcomes of using a free omental sheet graft versus other operative procedures for enteric perforation repair. Method: This study includes both prospective and retrospective comparative analysis. It was conducted on 150 patients admitted to the emergency ward of the Department of General Surgery at J.L.N. Medical College and Associated Group of Hospitals, Ajmer. Patients were randomly assigned to three groups, each consisting of 50 patients: GROUP A – Primary repair with the omental sheet, GROUP B – Primary repair alone, and GROUP C – Resection and anastomosis. Result: The rate of fecal fistula formation in each group was as follows: Group C had 6% of patients with fistula formation, Group B had 10%, and Group A had 2%. Regarding mortality, Group C and Group B had approximately 4% mortality each, while Group A had no mortality. Conclusion: Simple repair with a free omental sheet graft applied to the perforated site in the affected gut was successful. This approach likely prevents repair leaks, new perforations, and fecal fistulas by covering at least 10 cm of the affected gut. This significantly lowers both morbidity and mortality.