Comparison of Vicryl Versus Prolene Suture in Closure of Midline Rectus Sheath Following Elective Laparotomy: A Randomized Controlled Trial

ABSTRACT OBJECTIVES This aimed to compare the incidence of wound dehiscence and surgical site infections following midline rectus sheath closure with Prolene and Vicryl sutures after laparotomy. METHODOLOGY This prospective, randomized, controlled trial was conducted in the Department of General Surgery at Hayatabad Medical Complex, Peshawar, over 6 months. A total of 152 patients (aged 18–70 years) undergoing elective midline laparotomy were randomly divided into two groups using simple randomization by coin-flip method: Group A (Prolene) and Group B (Vicryl), each consisting of 76 patients. Both groups underwent standardized continuous mass closure with a 4:1 suture-to-wound length ratio. Post-operative follow-up continued for 30 days at post-operative days 7, 14, and 30, to assess wound dehiscence, surgical site infection, and hospital stay. Data were analyzed using SPSS version 23, with p ≤ 0.05 considered significant. RESULTSWound dehiscence occurred in 4 (5.3%) patients in the Prolene group compared with 10 (13.2%) in the Vicryl group (p<0.05). Surgical site infections were also significantly lower in the Prolene group 11 (14.4%) compared to the Vicryl 25 (32.9%) (p< 0.05). The hospital stay was slightly longer in the Vicryl group (7±2 vs 5±2), which was mainly due to post-operative complications (p< 0.05).CONCLUSIONClosure of the midline rectus sheath with Prolene results in significantly fewer cases of wound dehiscence and surgical site infections compared to Vicryl. Prolene may be considered a favorable option for midline laparotomy closure to minimize post-operative complications and improve patient outcomes.