To compare the efficacy of Modified Smead–Jones (MSJ) and Smead–Jones (SJ) sutures against continuous sutures in terms of wound infection, wound dehiscence, incisional hernia, and length of hospital stay, specifically focusing on randomized controlled trials and observational studies.
Key Findings:
MSJ significantly reduced wound dehiscence (RR = 0.29, p = 0.0006) compared to continuous sutures.
MSJ also significantly reduced wound infection (RR = 0.41, p = 0.0002).
No significant difference in incisional hernia risk between MSJ and SJ (RR = 0.17, p = 0.09).
Overall analysis showed a significant reduction in wound dehiscence and infection for MSJ compared to both SJ and continuous sutures.
Interpretation:
The Modified Smead–Jones suture technique appears to be more effective than both traditional Smead–Jones sutures and continuous sutures in reducing wound complications in emergency midline laparotomy closures.
Limitations:
Limited number of studies included (five studies with 403 patients), which may affect the robustness of the findings.
Heterogeneity observed in some analyses.
Publication bias assessment was not feasible due to insufficient studies.
Conclusion:
The Modified Smead–Jones suture technique may offer advantages in reducing wound-related complications compared to traditional methods, warranting further research to validate these findings.
