Comparison of the Vessel Loop Technique Versus Traditional Skin Closure for the Prevention of Surgical Site Infection Following Laparotomy in General Surgery.

Background Surgical site infection (SSI) remains a common and costly complication following laparotomy. Passive subcutaneous drainage using vessel loops has been proposed as a simple method to reduce incisional SSI, but evidence in laparotomy patients is limited. This study aimed to compare the incidence of incisional SSI between vessel loop-assisted skin closure and conventional skin closure following laparotomy in general surgery patients. Methods A retrospective cohort study was conducted on adult patients undergoing laparotomy for general surgical indications between January 2020 and January 2025. Patients were grouped according to skin closure technique: vessel loop-assisted closure (Vessiloop) or conventional closure without vessel loops. The primary outcome was to compare the incidence of SSI in laparotomy patients who had vessel loop insertion compared to conventional laparotomy closure. The secondary outcomes were to evaluate the association between patient comorbidities, surgical type, and the risk of SSI. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 27.0 (Released 2019; IBM Corp., Armonk, NY, USA). Results A total of 70 patients were included: 35 in the Vessiloop group and 35 in the conventional closure group. Patients in the conventional closure group were older, had a higher ASA score, and had an increased rate of gastrointestinal disease. Overall, six patients (8.6%) developed SSI. No SSIs occurred in the Vessiloop group, whereas six patients (17.1%) in the conventional closure group developed SSIs (p = 0.025). Univariate analysis demonstrated associations between SSI and smoking; the small number of smokers limits the reliability of this observation. Return to theatre, readmission, and 30-day mortality were similar between the two groups.​​​​​​​ Conclusion Vessel loop-assisted skin closure following laparotomy was associated with a lower incidence of incisional SSI in this retrospective cohort. However, baseline differences between groups may have contributed to the observed SSI rates. Larger prospective studies are warranted to validate these findings and define their role in SSI prevention.