Evaluation of the results of midline laparotomy closure in emergency surgery after the introduction of the fascial closure with small bites technique

Introduction: Laparotomy is an abdominal approach that increases morbidity and mortality in case of complications. The aim of this study is to elucidate the results of midline laparotomy closures performed by our team during 4 years and whether are differences between the techniques. Material and methods: The consecutive cases of midline laparotomies performed by our team between January 2016 and December 2019 were analyzed. Two groups were compared regarding patients characteristics and complications: the first with laparotomies closed with the large bites technique and the second one closed with the small bites technique. Results: 182 patients were included (72 in the large bites group and 110 in the small bites one). No differences in the characteristics of the patients were found, except in arterial hypertension. The percentage of wound infection in the large bites group was 16.7% compared to 9.1% in the small bites group. Acute fascial dehiscence was observed in 8.3% in the group of large bites and in 7.2% in the small bites group. The incisional hernia rate was 11.1% and 14.5% in the large bites group versus small bites group respectively. No statistically significant differences were observed between the two groups. Conclusions: Our results do not reach statistical significance. More studies are necessary to assess the optimal closure in emergency midline laparotomy.