Mass closure versus layered closure of midline laparotomy incisions: a prospective comparative study

Abstract

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, and cost effective while preventing both early and late complications. Present study is undertaken to compare the two methods (Mass closure and Layered closure) of laparotomy wound closure in relation to post-operative complications, time for wound closure and cost effectiveness in both groups and also to decide the most effective method among the two.Methods: This prospective comparative study was conducted in department of surgery at a tertiary care teaching hospital at Solapur (Maharashtra) from January 2006 to January 2009. On admission, patients suspected of having intraabdominal pathology, a thorough clinical e 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 late complications.Results: Total 60 patients of were studied. Majority of patients were in 61 to 65 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. Mass closure technique is more cost effective than layered closure group.Conclusions: Mass closure technique is less time consuming, more cost effective and safe for closure of midline laparotomy incisions.

Outcomes of Layered versus Mass Closure in Transverse Incision during Emergency Laparotomy in Children

“…It was observed that mean wound closure time was significantly less in mass closure group as compared to layered closure group (p < 0.001). Similar study was done by Deshmukh et al (2018) [17] and Kendall et al (1991) [18], they reported mean wound closure time in mass closure group was 16.2 minutes and 18 minutes respectively which were consistent with this current study.…”

“…In the present study post-operative wound infection rate was relatively high in Group A patients than Group B patients. We found, wound infection rate in mass closure group was 10% which was comparable with previous studies [17] [19]. On the other hand wound infection rate in layered closure group was 30.0% in this study, which was higher as compared to the previous studies [18] [20] [21].…”

“…In this current study incisional hernia was developed among 3.3% patients in mass closure group and 10.0% patients in layered closure group, that was comparable with previous studies [17] [20] [25]. But this finding was not similar to the study conducted by Kendall et al (1991) as documented that incisional hernia was 3.5% in layered closure group and 6.5% in mass closure group respectively [18].…”

Comparative study of wound sequlae in layer closure and retention closure of midline laparotomy

“…11 There was a male predominance with a M: F ratio of 2.84: 1. Similar male predominance in patients undergoing laparotomy was reported by Simpson et al and Deshmukh et al 12,13 In contrast to above studies the authors such as Singh et al reported a female predominance (1:2) in patients undergoing nontraumatic emergency laparotomy. 14 In our studies the other factors such as body mass index, serum albumin, total serum protein, hemoglobin and mean age of the affected cases was found to be comparable with no statistically significant difference (p>0.05).…”

A comparative study of the outcome of Mass Closure and Layered closure techniques for Midline Abdominal Incisions in a Teaching Hospital

“…A study by Israelsson et al; [10] and has also shown the rate of infection to be 7% in their study [9 of 2340]. In comparison to mass closure the wound infection in the present study was lesser in the layered closure in contract Deshmukh SN et al; [17] have found higher infection rates in layered closure when compared to mass closure. The difference could be because of the patient factors in wound healing.…”