2. Assistant professor of General Surgery Ain Shams University, 36 Iran street, Dokkii, Cairo, Egypt.
Background: Exploratory laparotomy is not an uncommon operation. and safe closure of laparotomy wound is the key to reduce the postoperative morbidity like wound pain, wound infection and incisional hernia.
Objective: To compare mass closure and Hughes repair in emergency laparotomy as regard intra operative technique, operative time, complications as wound infection, dehiscence and incisional hernia. Patients and methods: prospective comparative study between Mass closure and Hughes repair in emergency laparotomy. We include all patients 18 years old or older who underwent emergency laparotomy in Ain Shams University Hospital from September 2017 to March 2018 , we excluded patients with previous hernia and less than 18 years old. All patients were followed up for 6 months.
Results: We recruited 66 patients, (44) patients had mass closure, age range 22-88, 31 (70.5%) males, 13(29.5%) females ,(22) patients had Hughes repair, age range 22-89 ,14 (63.6%) males, 8(36.4%) females. Operative time in mass closure 15.25-/+ 1.6 , in Hughes repair 27.09-/+ 1.66. 6 patients ( 13.6)% developed incisional hernia after mass closure while 2 patients( 9.1% ) after Hughes repair, in comparison between the mass closure and Hughes repair ,7 patients ( 15.9%) developed wound infection after mass closure and 3 patients (13.6% ) after Hughes repair , Burst abdomen in 3 patients (6.8%) after mass closure , 1 patient (4.5%) after Hughes repair.
Conclusion: Hughes repair is associated with less incidence of incisional hernias and wound related complications and could be safely used.
Keywords: Incisional hernia, hughes repair, abdominla closure