An Observational Study of Abdominal Wound Closure Using Small Tissue Bites versus Large Tissue Bites in Midline Laparotomy Surgeries

Abstract

Background: Small tissue bite fascial closure may reduce wound complications following midline laparotomy compared with conventional large bites.

Methods: This prospective comparative study included 50 patients undergoing midline laparotomy, equally allocated to small bite and large bite closure groups. Operative parameters, postoperative wound complications, incisional hernia, and hospital stay were compared.

Results: Baseline characteristics were comparable between groups. The small bite group had significantly greater suture length (74.8 ± 9.5 vs 51.6 ± 7.8 cm; p<0.001) and SL:WL ratio (4.5 ± 0.5 vs 3.0 ± 0.4; p<0.001). SSI (8.0% vs 20.0%), seroma (4.0% vs 12.0%), burst abdomen (0% vs 8.0%), and incisional hernia at 6 months (4.0% vs 16.0%) were lower with small bites, although differences were not statistically significant. Hospital stay was significantly shorter with small bite closure (7.0 ± 1.8 vs 8.2 ± 2.3 days; p=0.04).

Conclusion: Small tissue bite closure achieved a higher SL:WL ratio and shorter hospital stay, with a consistent trend toward fewer wound complications and incisional hernias.