Mass Closure Comparison with Layered Closure in Midline Laparotomy Incisions

Abstract

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.