Published: 2017-11-23

A comparative study of two different techniques of subcutaneous tissue closure in abdominal surgery

Jyotsna S. Dwivedi, Alka S. Gupta, Sachin H. Pardeshi


Background: Surgical access to abdomen is required for many operative procedures. The subcutaneous tissue of the anterior abdominal wall can either be sutured or left unsutured with drain in situ. The purpose of this study was to compare the two methods of closure of the subcutaneous tissue and determine the benefit of one over the other.

Methods: The study was conducted in a tertiary care centre with sample size of 30 each in study and control group. Patients fulfilling the inclusion criteria were selected and depending on the randomisation the closure of subcutaneous tissue was done either by polyglactin 910, 2-0 or left unsutured with indigenously designed syringe suction drain kept in situ. The patients were followed up till the day of suture removal and further in case of any complications.

Results: Total duration taken for the procedure was significantly increased in the study group. There was a significant level of discomfort among the participants due to drain. The rate of surgical site infection, hospital readmission morbidity was significantly higher in the study group.

Conclusions: The type of drain studied was indigenously designed where the closed system was not maintained during charging the drain, hence further studies need to be conducted which will compare this with the other closed suction drains to determine the difference in the risk of wound complications.


Wound healing; polyglactin 910, surgical drains, surgical site infections

Full Text:



Harmon LA, HusenVR, Roberts EK, Abdominal closure. Medscape. 2017. Available at

Ranbhari NN, Knebel P, Diener MK, Seidlmayer C, Ridwelski K, Stoltzing H, et al. Current practice of abdominal wall closure in elective surgery - is there any consensus?. BMC Surg. 2009;9:8.

Bryan BM, Ali T, Stephen FJ. Incisions, closures, and management of the abdominal wound. In: Zinner MJ, Ashley SW, eds. Maingot’s Abdominal Operations. United States: McGraw-Hill Companies, Inc; 2007.

James J, Burke II, Gallup DG. Incisions for Gynecologic Surgery. In: Rock JA, Jones HW III, eds. TeLinde’s Operative Gynecology. 10th ed. New Delhi: Wolters Kluwer Health-Lippincott Williams and Wilkins; 2008:251-2.

Anderson ER, Gates S. Techniques and materials for closure of the abdominal wall in caesarean section (Review). The Cochrane Collaboration. Published by John Wiley and Sons Ltd. 2009:16-9.

Mohammad S. Surgical drains power point presentation. Available at

Allaire AD, Fisch J, Macmohan MJ. Subcutaneous drain versus suture in obese women undergoing caesarean delivery. J Reprod Med. 2000;45:327-31.

Magann EF, Chauhan SP, Palenik RS, Bufkin L, Martin Jr JN, Morrison JC. Subcutaneous stitch closure versus subcutaneous drain to prevent wound disruption after caesarean delivery: a randomized clinical trial. Am J Obstet Gynecol. 2002;186(6):1119-23.

Kumar SA. Subcutaneous drain versus subcutaneous stitch closure to prevent wound disruption after caesarean section. J Obstet Gynecol India. 2004:54(3):237-42.

Cardosi RJ, Drake J, Holmes S, Tebes SJ, Hoffman MS, Fiorica JV, et al. Subcutaneous management of vertical incisions with 3 or more centimeters of subcutaneous fat. Am J Obstet Gynecol. 2006;195(2):607-14.

Kaya E, Paksoy E, Ozturk E, Sigirli D, Bilgel H. Subcutaneous closed suction drainage does not affect surgical site infection rate following elective abdominal operations: a prospective randomized clinical trial. Acta Chirurgica Belgica. 2010;4:457-62.

Dwivedi JS, Gupta AS. Syringe suction vacuum drain: a cheap alternative. JPGO. 2014;1(4). Available at