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Incision and suturing abdominal wall is a common surgical practice and different methods of repairing and applying have aroused great interest among surgeons. This study aims to compare mass closure and layered closure in midline laparotomy incisions. This prospective comparative study was conducted in the surgical ward of Nangarhar University Hospital on 40 patients from June 2020 to June 2021. A and B were assigned to all of the patients randomly. Twenty patients received bulk closure and other twenty underwent multilayer closure. The time of surgery, wound infection, abdominal rupture, and other consequences were all compared across all patients. Patients were followed on Day 2, day 4, day 8, day 12, monthly for 3 months and after 6 months. The rate of wound infection in layered (group B) is higher as compared to mass closure (group A). In general, the wound infection rate in the multilayer closure group was 2 cases (10%) and 1 case (5%) in the mass closure group. In layered closure, event ratio was 10%, while in mass closure it was 5%. In multilayer closure, a buttonhole hernia was detected in one case (5%) and none in mass closure. In layered closure, sinus development was seen in two cases (10%), but not in mass closure. The method of closure by mass to close the midline laparotomy incisions is simple, easy to perform, and safer than Layered closure.
Incision and suturing abdominal wall is a common surgical practice and different methods of repairing and applying have aroused great interest among surgeons. This study aims to compare mass closure and layered closure in midline laparotomy incisions. This prospective comparative study was conducted in the surgical ward of Nangarhar University Hospital on 40 patients from June 2020 to June 2021. A and B were assigned to all of the patients randomly. Twenty patients received bulk closure and other twenty underwent multilayer closure. The time of surgery, wound infection, abdominal rupture, and other consequences were all compared across all patients. Patients were followed on Day 2, day 4, day 8, day 12, monthly for 3 months and after 6 months. The rate of wound infection in layered (group B) is higher as compared to mass closure (group A). In general, the wound infection rate in the multilayer closure group was 2 cases (10%) and 1 case (5%) in the mass closure group. In layered closure, event ratio was 10%, while in mass closure it was 5%. In multilayer closure, a buttonhole hernia was detected in one case (5%) and none in mass closure. In layered closure, sinus development was seen in two cases (10%), but not in mass closure. The method of closure by mass to close the midline laparotomy incisions is simple, easy to perform, and safer than Layered closure.
Background: The ideal method of abdominal wound closure remains to be discovered. It should be technically so simple that the results are as good in the hands of a trainee as in those of the master surgeon.The best abdominal closure technique should be fast, easy while preventing both early and late complications. Present study is undertaken to compare the two methods (LAYERED closure and MASS closure) of laparotomy wound closure in relation to postoperative complications,time for wound closure in both groups and also to decide the most effective method among the two. Methods: This study was conducted in department of surgery at a tertiary care teaching hospital at KANCHIPURAM (TAMILNADU) from DECEMBER 2019 to DECEMBER 2020. On admission,patients suspected of having intraabdominal pathology,a thorough clinical examination and general assessment was done.Necessary radiological and biochemical investigations were done to support the diagnosis. After confirmation of diagnosis patients were subjected for exploratory laparotomy.The laparotomy wound was closed with either by Mass closure or Layered closure technique. Patients were followed up for 6 months in post-operative period for detection of late complications. Results:Total 60 patients of were studied.Majority of patients were in 66 -75 age group.Male outnumbered the females. Incidence of early complications like seroma, wound infection is more in layered closure group as compared to mass closure.Mean wound closure time is more in layered closure group. Conclusions: Mass closure technique is less time consuming,safe for closure of midline laparotomy incisions.
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