Abdominal incisions: transverse vs vertical placement and continuous vs interrupted closure

Area of Science:

• Surgical Techniques
• Trauma Surgery
• Anesthesiology

Background:

• Previous retrospective reviews suggested continuous stitch closure could reduce operative times for emergency laparotomies.
• The efficiency and safety of different surgical closure methods require further prospective investigation.

Purpose of the Study:

• To prospectively evaluate the impact of continuous versus interrupted suture closure on operative time and complication rates in laparotomies for abdominal trauma.
• To compare transverse and vertical incision techniques in the context of abdominal trauma surgery.

Main Methods:

• A prospective, randomized study involving 551 patients undergoing laparotomy for abdominal trauma.
• Patients were randomized to transverse or vertical incisions and continuous or interrupted closure techniques.
• Outcomes measured included operative time, wound complications, and other postoperative complications.

Main Results:

• No statistically significant differences in time or complications were found between transverse and vertical incisions.
• Continuous suture closure was associated with an average time saving of 26 minutes (P = .02) compared to interrupted closure.
• No significant differences in overall complications were observed between continuous and interrupted closure methods.

Conclusions:

• Continuous suture closure of the abdominal wall is a practical method to reduce anesthesia and operating time.
• This technique does not increase the risk of wound or other postoperative complications.
• The findings support the adoption of continuous sutures for efficient abdominal wall closure in trauma laparotomies.