Lai, Larry Weng-Hong and Roslani, April Camilla and Yan, Yang-Wai and Bhojwani, Kavita M. and Jamaluddin, Mohamad Fadhil Hadi (2021) Comparison of post-operative pain in short versus long stitch technique for abdominal wall closure after elective laparotomy: A double-blind randomized controlled trial. ANZ Journal of Surgery, 91 (5). pp. 896-901. ISSN 1445-2197, DOI https://doi.org/10.1111/ans.16567.
Full text not available from this repository.Abstract
Background: Conventional mass closure uses suture-to-wound length ratio of 4:1 ('long stitch', LS). `Short stitch' (SS) has a suture-to-wound length ratio of more than 4 and incorporates only the linea alba, which may reduce tension and pain. We compared the post-operative pain after laparotomy closure using LS and SS. Methods: Patients undergoing elective midline laparotomy through standardized incisions in two tertiary hospitals from February 2017 to September 2018 were randomized to either LS or SS. The primary outcome was post-operative patient-controlled analgesia morphine usage at 24 h. Secondary outcomes were presence of surgical site infection and length of hospital stay (LOHS). Categorical variables were analysed using chi-squared analysis. Outcomes of study were tested for normal distribution. Skewed data were analysed using Mann-Whitney U-test. Results: Eighty-six patients were recruited (42 SS and 44 LS). The median age was 66 (interquartile range (IQR) 15). Majority were males (62.8%) and Chinese (50%). The median incision length was 17 cm in both groups. The median patient-controlled analgesia morphine usage 24 h post-operatively did not differ significantly (SS 21 mg, IQR 28.3; LS 18.5 mg, IQR 33.8, P = 0.829). The median pain score at rest (SS 1, IQR 1; LS 1, IQR 2, P = 0.426) and movement (SS 3, IQR 1; LS 3, IQR 2, P = 0.307) did not differ significantly. LOHS was shorter in the SS group (SS 6, IQR 4; LS 8, IQR 5, P = 0.034). The rate of surgical site infection trended lower in the SS group with no statistical difference. Conclusion: There were no differences in post-operative pain between SS and LS but we found that there were shorter LOHS in SS arm as secondary outcome.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Abdominal closure; General surgery; Post-operative pain; Short stitch; Surgical education |
| Subjects: | R Medicine > RD Surgery |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 04 Apr 2022 04:42 |
| Last Modified: | 04 Apr 2022 04:42 |
| URI: | http://eprints.um.edu.my/id/eprint/27845 |
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