Outcomes of Prophylactic Retaining Suturing in Patient Undergoing Emergency Midline Laparotomy

Objective: This study aims to determine the clinical outcomes of prophylactic retaining suturing (PRS) in patients undergoing emergency midline laparotomy. Methods: This descriptive cross-sectional study was conducted at the Department of Surgery, Ghulam Muhammad Mahar Medical College, Sukkur from September 2024 to April 2025. All patients aged 18–65 years undergoing emergency midline laparotomy were enrolled. Patients received standardized abdominal closure using continuous looped No. 1 monofilament nylon sutures, supplemented with prophylactic retention sutures. Patients were followed for 30 days postoperatively. Wound dehiscence (WD) and surgical site infection (SSI) were recorded once during this period as an outcome. Moreover, postoperative pain was assessed at different time interval using the Visual Analogue Scale. Results: Out of 242 patients, the mean age was 44.83 ±6.46 years. The incidence of SSI was obsreved in 29 (12.0%) and WD in 13 (5.4%) patients. Diabetes Mellitus (p-value < 0.001) and smoking status (p-value < 0.001) were significantly associated with both SSI and WD. Postoperative pain showed a statistically significant reduction from baseline to 72 hours after surgery (p-value < 0.001). However, no significant difference was observed in pain scores with respect to the presence of SSI (p-value = 0.822) or WD (p-value = 0.130). The mean hospital stay was 11.26 ±2.24 days, with no significant difference based on the presence of SSI (p-value = 0.626) or WD (p-value = 0.861). Conclusion: PRS in emergency midline laparotomy demonstrated low complication rates and effective pain control without prolonging hospital stay, supporting its safe use in high-risk patients.