Hughes abdominal wall repair versus conventional mass closure: Our initial results.

Background: Hughes technique (far-and-near) combines a standard mass closure (two loop 1-PDS sutures) with a series
of horizontal and two vertical mattress sutures within a single suture (1-Nylon). So, this will spread the loading over the
length of the incision in addition to across it. This technique may be more effective for preventing the development of
incisional hernia after a closure of the midline incisions.
This study aimed to compare two techniques of midline abdominal incision closure: Hughes technique versus mass
closure as regards: the incidence of wound dehiscence (burst abdomen or incisional hernia).
Patients and Methods: A prospective randomized trial was designed. A total of 575 patients underwent midline laparotomy incisions (for elective or emergency surgery), the midline wounds of 288 patients were closed using the Hughes technique while the wounds of the other 287 patients were closed by the classic mass closure technique.
The incidence of burst abdomen at the end of 30-day postoperative served as the main outcome measure. The incidence of incisional hernia at the end of the first year, as determined by a thorough clinical examination and radiographic evidence obtained by ultrasound, was the secondary outcome.
Results: Compared with traditional abdominal closure, the incidence of incisional hernias was considerably lower in
Hughes's abdominal repair.
Conclusion: In both emergency and elective laparotomy instances, Hughes's abdominal wall closure was better than
conventional closure in terms of preventing wound dehiscence and subsequent incisional hernias. To adequately analyze
these results, this study has to be carried out with a bigger sample size and for a longer duration of follow-up.