JENKIN’S VERSUS ISRAELSSON’S TECHNIQUE FOR ABDOMINAL CLOSURE AFTER LAPAROTOMY AND IT’S OUTCOME, A RANDOMISED CONTROL TRIAL.

Mithlesh wanchoo; Javid Iqbal; Rahul Singh; Ankur Bhat

Mithlesh wanchoo GMC KATHUA https://orcid.org/0000-0002-4660-012X
Javid Iqbal
Rahul Singh
Ankur Bhat

Keywords: Midline laparotomy, incisional hernia, Israelsson’s technique, Jenkin’s technique, wound dehiscence

Abstract

Background: Midline incisions allow rapid and comprehensive access to the abdominal cavity. Secure wound closure is essential for an uncomplicated and expedient recovery after laparotomy. Method: A Randomised control trial was conducted on patients admitted in the department of surgery at a tertiary care centre from 1^st November 2020 to 31^st October 2021. Patients were divided into two groups by randomisation using computer generated randomisation chart. In one group midline laparotomy was closed by Jenkin’s technique (Group 1) in other group by Israelsson’s techniques(Group 2) and outcomes related to closure technique were compared. Aim: To study the results of two techniques in terms of postoperative complications. Results: A total of 100 patients were enrolled in this study with age varied from 18 to 85 years. Male: female ratio was 4.5:1. The mean BMI was 21.95. Of those who were closed by Group 1, 28% developed postoperative wound infections compared to 16% in Group 2. Group 1 had a wound dehiscence rate of 18%, while Group 2 had 6%. Group 1 recorded an incidence of 6% of burst abdomen compared to the 2% in Group 2. In Group 1, there was a 16% incidence of incisional hernia while there was a 6% incidence in Group 2. In Group 1, only 4% of patients complained of chronic wound pain compared to the 6% in Group 2. Conclusion: Jenkin’s abdominal closure technique should be employed in closing large midline incisions in procedures requiring less operative time. This technique involves less operative. Israelsson’s technique leads to lesser wound infections, wound dehiscence, burst abdomen and incisional hernia as compared to Jenkin’s technique. Israelsson’s technique should be used in patients who can tolerate an added amount of operative time, extra cost, have small midline incisions and with associated pulmonary diseases.

Author Biographies

Javid Iqbal

Assistant Professor, Department of Surgery, Government Medical College Jammu, Jammu and Kashmir, India.

Rahul Singh

Senior Resident, Department of Surgery, Government Medical College Jammu, Jammu and Kashmir, India.

Ankur Bhat

Senior Resident, Department of Surgery, MM Medical College & Hospital, Solan, Himachal Pradesh, India

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