Comparative study of free omental sheet graft and other operative procedures of enteric perforation repair.
OBJECTIVE
In developing countries, enteric perforation due to typhoid continues to have very high morbidity and mortality rates irrespective of the type of operative procedure performed. The aim of the present study was to evaluate the effectiveness of a free omental sheet graft in perforated typhoid enteritis, in comparison to other methods of enteric perforation repair in terms of decreased morbidity, mortality and cost-effectiveness.


METHODS
A non-randomized study of 114 patients with enteric perforations was carried out over a period of 4.5 years. The study was divided in two groups; group I includes 38 cases in which a free omental sheet graft was used in typhoid enteritis with perforation and group II includes 76 cases in which other surgical procedures for enteric perforation repair were used. The outcomes were measured in relation to postoperative complications and mortality.


RESULTS
The incidence of complications including faecal fistula was 2.6% in group I (free omental sheet graft group) versus 32.89% in group II. The mortality rate of 2.6% was also lower in group I versus 19.7% in group II.


CONCLUSIONS
This study concludes that the use of free omental sheet graft on typhoid enteric perforation site is effective in lowering the repair leak rate and thereby decreases the morbidity and mortality associated with these procedures. By lowering the complication rates, it also entails reduction in financial burden.
Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India, dr.amit5280@gmail.com.
Amit
A
Singh
Nandkishore
N
Gora
Murari Lal
ML
Soni
Radha Govind
RG
Khandelwal
Shivaji H
SH
Vidyarthi
Chandra Kumar
CK
Thounaojam
Umesh
U
Sharma
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D007412:Intestinal Fistula / Q000209:etiology*; D007416:Intestinal Perforation / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D010538:Peritonitis / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000209:etiology; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014435:Typhoid Fever / Q000150:complications*; D055815:Young Adult