Madhuri, Sudhakar (2017) A Comparative study of 2-0 Vicryl Vs 2-0 Prolene for Rectus Closure. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: The finest duty of a surgeon is letting a wound heal by primary intention. Among all wound closures, abdominal wound closure is the most challenging task for a surgeon. There are different techniques according to suture material, suturing technique and length of suture material that have been suggested optimal for rectus closure. These prospects are still under study and are controversial. Early dehiscence usually occurs from the fifth to eighth post operative day presenting as serosanguinous discharge from wound site and feeling of ‘give way’’ . Collagen formation in a wound occurs by two weeks until which the tensile strength of the suture material is required to provide mechanical strength to the wound. The tensile strength of vicryl is two to three weeks and that of prolene is many years. Theoretically vicryl has no disadvantage over prolene in rectus closure. AIMS AND OBJECTIVES: PRIMARY OBJECTIVE: • To compare the use of 2-0 vicryl and 2-0 prolene for rectus closure in both emergency and elective cases and following up their rates of early dehiscence. MATERIALS AND METHODS: PLACE OF STUDY: Department of General Surgery, Govt. Stanley Medical College and Hospital, Chennai DURATION: 6 months. STUDY DESIGN Prospective Study. SAMPLE SIZE: 40 patients. INCLUSION CRITERIA: All Patients Undergoing Laparotomy for All Pathologies Elective Settings EXCLUSION CRITERIA: • Old age >80 years, • COPD, • Morbid Obesity, • Chronic Steroid Intake. METHODOLOGY: Ethical clearance will be obtained from the institute ethical committee • Written informed consent will be obtained from all patients before subjecting them for the study • All patients undergoing midline laparotomy in both elective and emergency setting (other than exclusion criteria ) are registered and followed up in the early post operative period upto two weeks watching out for wound dehiscence. • Patients are divided into two groups A and B. A – 2-0 Prolene used for closure, B- 2-0 vicryl used for closure. • All wounds are closed in a standardized manner to prevent bias, ratio of suture material length to wound length being 4:1, continuous suturing, inter suture distance 1 cm, and distance from wound edge being 2 cm. • Patients are followed upto two weeks of surgery. • The observations were recorded and tabulated. CONCLUSION: Rectus closure and prevention of Burst Abdomen remains a controversial topic with ever evolving new concepts. There is no single technique that is perfect and risk free. Apart from suture material, technique, patient comorbidities and intra op conditions the surgeons experience also counts. My study reveals several factors contributing to Burst Abdomen and that there is no significant association between the usage of absorbable and nonabsorbable material. Though vicryl is absorbed faster than prolene it remains in the wound edges until it is bridged by collagen. There are other associated factors that influence wound strength and healing. The limitations of my study are that the patients have been followed only for a short duration (two weeks) and the development of incisional hernia was not observed.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.221411057 |
| Uncontrolled Keywords: | 2-0 Vicryl, 2-0 Prolene, Rectus Closure, Comparative study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 02 Mar 2020 01:07 |
| Last Modified: | 02 Mar 2020 01:07 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12076 |
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