A Comparative Study Between Continuous and Interrupted Suturing of Rectus Sheath Closure in Caesarean Section Patients at a Tertiary care Teaching Hospital.

Abstract

Background: Caesarean delivery may be followed by several complications, surgical site infection (SSI) being one of them. The rate of SSI ranges from 3 to 15% worldwide (1-6). SSI is associated with a maternal mortality rate of up to 1.33%. (3) It places physical and emotional burdens on the mother and her family.

Aim: Study aimed to compare incidence of incisional SSI in two techniques of rectus sheath closure: the conventional continuous method and intermittent in patients undergoing caesarean section.

Methods: Comparative observational study of total 578 patients who underwent caesarean sections was enrolled in the study. These were divided into two equal groups of 289 each and assigned as either continuous or intermittent rectus sheath closure group. Standard surgical steps and post-operative care given to all. Wound complications were analysed in both groups.

Results: Out of total 578 LSCS studied, we have found 47 SSI (8.1%); 10 (3.4%) SSI found in intermittent rectus sheath closure group which is less than in continuous group, 37 (12.8%). Intermittent closure group is associated with less induration, pain at the wound site, serous discharge, and spontaneous superficial dehiscence. Resuturing need was less in intermitant group but significant difference not noted between the two groups (p = 0.651).

Conclusion: Intermittent suturing of rectus sheath is associated with a lower incidence of SSI and fewer clinical manifestations compared to continuous suturing in caesarean section. Adopting the intermittent suturing technique for rectus sheath closure would significantly reduce post-operative complications like wound discharge, wound dehiscence, and improve patient outcomes.