COMPARISON OF POST-OPERATIVE OUTCOMES OF MASS CLOSURE CONTINUOUS TECHNIQUE VS HUGHES REPAIR IN PATIENTS UNDERGOING EXPLORATORY LAPAROTOMY

SS ULLAH; MURK HIRAJ; MF SHAH; M ZAKRIA; M SHAHID

doi:10.54112/bcsrj.v2024i1.807

Authors

SS ULLAH Department of General Surgery, Nishtar Hospital Multan, Pakistan
MURK HIRAJ Department of General Surgery, Nishtar Hospital Multan, Pakistan
MF SHAH Department of General Surgery, Nishtar Hospital Multan, Pakistan
M ZAKRIA Department of Cardiac Surgery, Nishtar Hospital Multan, Pakistan
M SHAHID Department of General Surgery, Nishtar Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.807

Keywords:

Abdominal Closure Techniques; Exploratory Laparotomy; Hughes Repair; Mass Closure Continuous; Postoperative Complications

Abstract

Surgical techniques for abdominal closure following exploratory laparotomy play a crucial role in determining postoperative complications. The mass closure continuous approach and Hughes repair are commonly employed methods with unique characteristics and outcomes. Objective: This retrospective comparative study aimed to evaluate the incidence of postoperative complications associated with the mass closure continuous approach and Hughes repair in patients undergoing exploratory laparotomy. Methods: The study was conducted at Nishtar Hospital Multan from July 2023 to December 2023. A total of 50 patients aged between 18 and 60 years of both genders, undergoing exploratory laparotomy, were included through non-probability sampling. Patients were treated either with the mass closure continuous technique or Hughes repair for abdominal closure. The mean operative time for each technique was recorded. The incidence of postoperative complications, including incisional hernia, wound infection, abdominal burst, and seroma, was assessed. Statistical analysis was performed using appropriate methods. Results: The mean operative time for the mass closure continuous technique was 16.32±2.1 minutes, significantly lower than that of Hughes repair (p<0.0001). Patients treated with Hughes repair demonstrated a significantly lower incidence of incisional hernia, wound infection, abdominal burst, and seroma compared to those treated with the mass closure continuous technique. Conclusion: Hughes's repair technique for abdominal closure following exploratory laparotomy is associated with reduced occurrence of postoperative complications, including incisional hernia and wound-related issues. Therefore, it may be considered a safe and effective option for abdominal closure in these patients.

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References

Bozzay JD, Walker PF, Schechtman DW, Shaikh F, Stewart L, Tribble DR, et al. Outcomes of exploratory laparotomy and abdominal infections among combat casualties. Journal of Surgical Research. 2021;257:285-93.

Pooria A, Pourya A, Gheini A. A descriptive study on the usage of exploratory laparotomy for trauma patients. Open Access Emergency Medicine. 2020:255-60.

Olanrewaju OA, Saleem A, Owusu FA, Pavani P, Ram R, Varrassi G. Contemporary Approaches to Hernia Repair: A Narrative Review in General Surgery. Cureus. 2023;15(12).

Zaitoun MA, Algazar M, Elhorbity MA. Efficacy of far-near-near-far (Hughes) technique in closure of midline exploratory wound for reducing the incidence of incisional hernia in comparison with conventional mass closure. The Egyptian Journal of Surgery. 2020;39(4):900-5.

Cochetti G, Abraha I, Randolph J, Montedori A, Boni A, Arezzo A, et al. Surgical wound closure by staples or sutures?: Systematic review. Medicine. 2020;99(25).

Kimura S, Tsuji T. Mechanical and immunological regulation in wound healing and skin reconstruction. International journal of molecular sciences. 2021;22(11):5474.

Heger P, Pianka F, Diener M, Mihaljevic A. Current standards of abdominal wall closure techniques: conventional suture techniques. Der Chirurg. 2016;87:737-43.

van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World journal of surgery. 2010;34:20-7.

Muysoms FE, Antoniou S, Bury K, Campanelli G, Conze J, Cuccurullo D, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19:1-24.

Godara R, Garg P, Shankar G. Comparative evaluation of Cardiff repair and mesh plasty in incisional hernias. Internet J Surg [Internet]. 2007;9.

Rajasekaran C, Vijaykumar K, Arulkumaran M, Meera S. A randomized controlled study to compare the efficacy of hughes abdominal repair with conventional abdominal closure-to reduce the incidence of incisional hernias in Indian population. International Surgery Journal. 2017;4(7):2291-3.

Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). British Journal of Surgery. 2022;109(10):943-50.