Background: Midline laparotomy incision is still the most common approach for many digestive, vascular [especially aortic] and abdominal trauma surgery procedures.
The aim of the work: This work aimed to compare the post-operative outcomes of simple closure and tension suture post exploratory laparotomy in high-risk patients regarding wound dehiscence, infection and late incisional hernia in 6 months follow up.
Patients and Methods: This prospective randomized study was conducted on 24 high-risk patients undergoing exploratory laparotomy regarding wound dehiscence, infection and late incisional hernia in 6 months follow up divided into two groups: Group [I]: with simple closure technique [12 patients] and Group [II]: with additional tension suture of midline closure technique [12 patients] in Surgery department at Damietta Faculty of Medicine, Al Azhar University.
Results: There was statistically significant difference between the studied cases as regard suture length while there was no statistically significant difference between the studied cases as regard complications, hospital stays, Closure time, indications of laparotomy and etiology.
Conclusion: The tension method of suturing also requires significantly more suture material than the conventional continuous method. Tension suture method of suturing is better than the conventional continuous method in the management of closure of emergency vertical midline laparotomy incision as the post-operative complications occurred less frequently in patients with tension sutures but without statistical significance.