Prospective comparative study of modified Smead Jones versus conventional continuous method of fascial closure in emergency midline laparotomy

Chirag B. Aghara, Ajay M. Rajyaguru, Jatin G. Bhatt


Background: A midline incision is simple, quick, bloodless and provides excellent exposure. So it is most commonly used access route for emergency laparotomy. But compare to other incision it increases incidence of postoperative wound dehiscence and an incisional hernia. Prevention of this complication is important in reducing post-operative morbidity and mortality. Present study was undertaken to compare the effectiveness of modified Smead Jones versus conventional continuous closure technique in terms of wound infection and wound dehiscence.

Methods: A total of 100 patients from July 2017 to November 2019 were randomized in two groups of 50 each. Group A in which linea alba closure was done by modified Smead Jones technique and group B in which linea alba closure was done by conventional continuous closure technique.

Results: 12 patients in group A and 28 patients in group B developed wound infection and 1 patient in group A and 7 patients in group B developed wound dehiscence.

Conclusions: Modified Smead Jones technique is better than conventional continuous closure technique in management of closure of emergency midline laparotomy.



Continuous closure, Emergency midline laparotomy, Modified Smead Jones technique, Wound dehiscence

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