Subcuticular with interrupted suturing ; technique for abdominal wound closure

Closure of the wound after surgery is a routine procedure and one of the first things that a surgeon in training should learn. A surgeon will successfully close a thousand of wounds during his career, but the problem of wound infection remains challenging. This study was conducted to compare between two methods of skin closure which are subcuticular alone and combined subcuticular with interrupted suturing regarding; wound infection, cosmesis &speed of wound closure. Between December 2006 and October 2009, two hundred and two patients were admitted in Basrah General Hospital, department of surgery. They underwent elective abdominal operation and were randomized into two groups / group A (abdominal skin closure by subcuticular suturing only) and group B (combined subcuticular with interrupted suturing). There were 102 cases in the subcuticular group, 50 cases of them were males and 52 cases were females, while in group B there were 100 cases,42 cases of them were males and 58 cases were females. Mean age was 38.9 (range 4-66) for group A and 41.6 (range 8-67) for group B. The mean BMI was 25.2 (range 17.4-34.8) for group A and 26.4 (range 18.7-39) for group B. Results: Wound infection: The total number of early wound infection for the six -weeks follow -up period was 12 cases (11.7%) for the subcuticular (group A),and 4 cases (4%) for the combined (group B)_(P = 0.036). Cosmoses: There was no significant difference in cosmetic result in both groups. Speed of wound closure: Combined (group B) closure was accomplished at significantly faster rate (mean 35.6 sec / cm) than subcuticular (group A) closure (mean 46.8sec / cm) (p = 0.001). Conclusion: From this study we conclude that the choice of technique for wound closure did not affect the final cosmetic outcome of the wound but the incidence of postoperative wound infection significantly reduced by combined subcuticular and interrupted suturing. The closure of wound is rapid in combined group than in subcuticular group alone.