Abdominal fascial dehiscence in continuous and figure of eight interrupted suture technique for rectus sheath closure following an emergency laparotomy:A Randomized Controlled Trial

In emergency surgery, midline exploratory laparotomy is crucial in diagnosing and treating a wide range of life-threatening abdominal conditions [1] Abdominal fascial dehiscence remains a formidable challenge in surgical practice, particularly in emergency laparotomies, where the urgency of intervention often complicates procedural considerations..

Following emergency midline laparotomy, patients are at risk of experiencing a spectrum of complications, both early and late in their postoperative course.Early complications of emergency midline laparotomy may includes burst abdomen and partial dehiscence, while late complications could involve incisional hernia.[2] The risk of fascial dehiscence is notably higher in emergency midline laparotomy compared to elective procedures. This elevated risk stems from the challenges inherent in emergency situations, where preoperative assessment may not be conducted as thoroughly, and the procedure is often performed with multiple risk factors. Malnutrition emerges as a significant risk factor in such scenarios, contributing to increased rates of fascial dehiscence. Consequently, postoperative management necessitates the administration of adequate protein supplementation to decrease this risk and promote optimal healing outcomes.[3] Wound dehiscence rate was found to be 12.4% in emergency midline laparotomy [4]