A COMPARATIVE STUDY BETWEEN SUBCUTICUALR AND MATTRESS SUTURES IN INGUINOSCROTAL SURGERIES

Abstract

Background: A good cosmetic scar gives patient good satisfaction along with mental ease to the surgeon performed the surgery. Cosmesis is an important aspect in present day to day scenarios. Scar is the only visible thing to patient but not the procedure of surgery. So a good cosmetic scar means good surgery for any patient. Latest advancements in surgical procedures like minimally invasive surgeries, laparoscopic surgeries and robotic surgeries are mainly to reduce the scar size for patients and to get a good cosmetic appearance. For only skin closure various techniques like various skin closure techniques, skin staples, clips, sterile strips and glue adhesives are available.

Methods: The study is conducted in 200 patients in S.V.R.R.G.G.H hospital, Tirupati in department of general surgery. First 200 patients operated for inguinoscrotal swellings who met all the inclusion criteria in Department of General Surgery in SVRRGGH, TIRUPATI. Patients was given consecutive numbers and all the patients with odd number were sutured by Mattress technique and even number were sutured by Subcuticular technique. In all the selected patients wound closure was done according to the depth in layer wise manner. Care was taken to secure good hemostasis and good approximation of wound edges. Wound size and time taken for wound closure was noted in all patients using Flexible scale and Stop watch. Post operative examination  of wound was done on 3^rd day, 5^th day, 1 month, 2 months and 3 months. Closure by Mattress sutures in 50% of patients and by Subcuticular sutures in other 50% of patients.

Results: In present study comparison between vertical mattress and sub cuticular  closure techniques in clean inguinoscrotal surgeries was done. In present study we get to know that, time taken for skin closure was significantly less for vertical mattress    technique when compared to sub cuticular technique. Post operative pain was more in vertical mattress technique when compared  to subcuticular technique on post operative day 0, 1, 3 and 5. Post operative wound complications were more in vertical mattress technique  when compared to subcuticular technique. Cosmesis of the scar is better in subcuticular technique when compared to  vertical mattress technique.

Conclusion: From the above findings we can get a conclusion that except in time taken for procedure Sub cuticular technique is superior when compared to Vertical mattress technique. The time taken for closure can be reduced even in cases of sub cuticular technique by more and more practice of that technique.