Effects of Stitch Length on Wound Complications After Closure of Incision

Rizwan Jalanee; Muhammad Amjad Choudhary; Khurram Arif; Irfanullah Khan; Muhammad Hussain; Sana Ullah Kakar

doi:10.70749/ijbr.v3i1.424

Authors

Rizwan Jalanee Department of Paediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.
Muhammad Amjad Choudhary Department of Paediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.
Khurram Arif Department of Paediatric Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.
Irfanullah Khan Department of Paediatric Surgery, Aga Khan University & Hospital, Karachi, Sindh, Pakistan.
Muhammad Hussain Department of Paediatric, Sandman Provincial Hospital, Quetta, Balochistan, Pakistan.
Sana Ullah Kakar Baluchistan Institute of Psychiatry and Behavioural Sciences (BIPBS), Quetta, Balochistan, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i1.424

Keywords:

Stitch Length, Wound Complications, Surgical Site Infections, Incisional Hernias, Wound Healing, Suture Technique

Abstract

Background: Surgical incision closure is essential for wound healing and postoperative recovery. Stitch length plays a critical role in preventing complications such as infection, dehiscence, and delayed healing. Optimal stitch length ensures tissue approximation without excessive tension, yet its precise impact on wound complications remains unclear. Objective: This study aims to evaluate the effects of different stitch lengths on wound complications after surgical incision closure, with a focus on surgical site infections (SSIs), incisional hernias, and delayed healing. The goal is to identify optimal suture techniques for better postoperative outcomes. Methods: A comparative study was conducted at a tertiary care hospital Pakistan Institute of Medical Sciences PIMS, involving 200 patients who underwent midline incision closure with either long or short stitch lengths. Data were collected through patient interviews, direct observations, and medical record reviews. Wound complications and recovery parameters were analyzed to identify significant patterns and risk factors. Results: The study found significantly higher rates of wound complications, including superficial and deep infections, wound dehiscence, and incisional hernias in the long stitch group compared to the short stitch group. Shorter stitch lengths resulted in a higher SL to WL ratio and fewer complications. Conclusion: Shorter stitch lengths with a higher SL to WL ratio reduce the incidence of wound complications following surgical incision closure. These findings suggest that adopting shorter stitch lengths may improve patient recovery and minimize healthcare costs associated with postoperative complications.

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References

Fani, N., Moradi, M., Zavari, R., Parvizpour, F., Soltani, A., Arabpour, Z., & Jafarian, A. (2024). Current advances in wound healing and regenerative medicine. Current stem cell research & therapy, 19(3), 277-291. https://doi.org/10.2174/1574888X18666230301140659

Słonimska, P., Sachadyn, P., Zieliński, J., Skrzypski, M., & Pikuła, M. (2024). Chemotherapy-mediated complications of wound healing: An understudied side effect. Advances in Wound Care, 13(4), 187-199. https://doi.org/10.1089/wound.2023.0097

Maurício, A. C., Alvites, R., & Gönül, M. (Eds.). (2023). Wound Healing: Recent Advances and Future Opportunities.

Chen, Y., Chai, M., Xuan, C., Lin, J., Yang, H., Li, C., Xie, M., Serge Ostrovidov, Shi, X., & Mao, C. (2024). Tuning the properties of surgical polymeric materials for improved soft-tissue wound closure and healing. Progress in Materials Science/Progress in Materials Science, 143, 101249–101249. https://doi.org/10.1016/j.pmatsci.2024.101249

Ehlers, C. F. (2024). Integumentary Disorders and Wound Management. In Acute Care Physical Therapy (pp. 639-680). Routledge.

Weber, M., Lenz, M., Wassenberg, L., Perera, A., Eysel, P., & Scheyerer, M. J. (2024). Thermographic assessment of skin temperature after lumbar spine surgery: Useful method for detection of wound complications? A pilot study. Technology and Health Care, 32(5), 3497–3504. https://doi.org/10.3233/thc-240344

Buote, N. J. (Ed.). (2022). Soft Tissue Surgery, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book: Soft Tissue Surgery, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book (Vol. 52, No. 2). Elsevier Health Sciences.

Fritts, H., Herrick, G., Frasier, K., Babkowski, N., & Radillo, K. (2024). Fastening the Future: Surgical Zip Ties for Enhanced Wound Closure and Patient Well-Being. Journal of Surgery & Anesthesia Research. SRC/JSAR-230. 5, 187, 2-7. https://doi.org/10.47363/JSAR/2024

Brown, K. R., & Hawn, M. T. (2023). Operative Techniques in Vascular Surgery. Lippincott Williams & Wilkins.

Kohno, S., Hasegawa, T., Aoki, H., Ogawa, M., Yoshida, K., Yanaga, K., & Ikegami, T. (2022). Analysis of risk factors for surgical site infection and postoperative recurrence following inguinal and femoral hernia surgery in adults. Asian Journal of Surgery, 45(4), 1001-1006. https://doi.org/10.1016/j.asjsur.2021.08.019

Hidalgo, N. J., Juvany, M., Guillaumes, S., Hoyuela, C., Vidal, Ó., & Pera, M. (2024). Effect of topical gentamicin in preventing surgical site infection in elective incisional hernia repair in a randomized controlled trial. Scientific Reports, 14(1), 28755.

https://www.nature.com/articles/s41598-024-80112-y

Söderbäck, H., Masood, A., Leo, J., & Sandblom, G. (2022). Introduction of small stitch small bite technique: a retrospective long-term follow-up. Langenbeck's Archives of Surgery, 407(6), 2527-2535. https://link.springer.com/article/10.1007/s00423-022-02530-8

Yii, E., Onggo, J., & Yii, M. K. (2023). Small bite versus large bite stitching technique for midline laparotomy wound closure: A systematic review and meta-analysis. Asian Journal of Surgery. https://doi.org/10.1016/j.asjsur.2023.08.124

Sanchez, V., Mahadevan, K., Ohlson, G., Graule, M. A., Yuen, M. C., Teeple, C. B., ... & Wood, R. J. (2023). 3D knitting for pneumatic soft robotics. Advanced Functional Materials, 33(26), 2212541. https://doi.org/10.1002/adfm.202212541

Kouzu, K., Tsujimoto, H., Ishinuki, T., Shinji, S., Shinkawa, H., Tamura, K., ... & Mayumi, T. (2024). The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. Journal of Hospital Infection, 146, 174-182. https://doi.org/10.1016/j.jhin.2023.09.006

Ranucci, C. M., Lai, Q., Quaresima, S., Paganini, A. M., Celani, S., Rossi, M., ... & Di Saverio, S. (2023). New Trends in Laparoscopic Procedures in the Emergency Abdominal Surgery. In The High-risk Surgical Patient (pp. 269-278). Cham: Springer International Publishing. https://link.springer.com/chapter/10.1007/978-3-031-17273-1_23

Brioschi, M. L., Lemos, S. C. M., Neto, C. D., De Meneck, F., Resende, P. R., & Neves, E. B. (2023). Identification of body contouring surgery complications by multispectral RGB/infrared thermography imaging. Body Contouring-Surgical Procedures and New Technologies. Intech Open, 1-13.

Prakash, M., Mathikere Naganna, C., Radhakrishnan, V., Somayaji, P., & Sabu, L. (2024). Therapeutic potential of silkworm sericin in wound healing applications. Wound Repair and Regeneration, 32(6), 916-940. https://doi.org/10.1111/wrr.13216