A Prospective Study of Sutured Versus Non-sutured Subcutaneous Fat Tissue in Laparotomy Wound Closure

Background This study was conducted to determine the wound-related complications, such as wound dehiscence, delayed post-operative stay, and reinterventions in both groups, and compare the incidence of surgical site infection in elective laparotomy wounds in two groups - those with closing subcutaneous fat tissue and those without. Methods At the Government Medical College, Thrissur, 248 patients undergoing elective abdominal surgeries during the period from August 2019 to August 2020 participated in this one-year prospective cross-sectional study. The institutional ethics committee approved the study, and participants provided written informed consent. Patients were randomly assigned to the subcutaneous closure group (S) and the non-closure group (N). Post-operative events were then systematically documented. Results The group with no subcutaneous suture (N) had a considerably greater percentage of patients with seromas (12 patients, 9%), hematomas (13 patients, 10.5%), superficial surgical site infection and total wound dehiscence as compared to the subcutaneous tissue closure group (S). Groups N and S displayed comparable numbers of suture sinus developments and partial wound dehiscence. Group N and Group S had similar hospital stays, according to the overall length of stay displayed. Conclusion Subcutaneous suturing during elective laparotomy wound closure significantly reduced superficial surgical site infection, hematoma, seroma, and total wound dehiscence; in the remaining categories, subcutaneous and non-subcutaneous sutures did not differ significantly. It also did not help to reduce hospital stays.