Question

You have just completed a laparotomy for peritonitis due to a perforated peptic ulcer. What is the best surgical strategy for avoidance of a complete abdominal wound dehisence?

a. use of skin clips to close the skin rather than sub cuticular sutures
b. careful approximation of the peritoneum with non absorbable sutures
c. mass closure of the midline wound using a 1 polydiaxone suture
d. direct apposition of the rectus muscle rather than linea alba aponeruosis
e. mass closure of the midline wound using a 3/0 polypropylene suture

Answer 1

The best surgical strategy for avoidance of a complete abdominal wound dehiscence is mass closure of the midline wound using a 3/0 polypropylene suture.

Step-by-step explanation:

The best surgical strategy for avoidance of a complete abdominal wound dehiscence after a laparotomy for peritonitis due to a perforated peptic ulcer is e. mass closure of the midline wound using a 3/0 polypropylene suture.

Mass closure of the wound refers to the technique of suturing all layers of the abdominal wall together, including the peritoneum, muscles, and fascia, to achieve strong and secure wound closure. The use of a 3/0 polypropylene suture provides adequate strength and durability.

Skin clips (option a) are not recommended for closure of the abdominal wound, as they only secure the skin layer and do not provide deep tissue support. Careful approximation of the peritoneum (option b) is important, but it should be combined with mass closure to ensure overall wound integrity.