A Comparative Study of Single Layer Closure and Conventional Layered Closure of Laparotomy Wounds

OBJECTIVE: To compare the techniques of single layer closure and conventional layered closure of laparotomy wounds on the basis of operative time and post-operative complications. METHODS: Prospective randomized study of 100 patients who underwent laparotomy in a tertiary care hospital in Karnataka, for abdominal surgical problems needing either emergency or elective surgery. Out of these 100 patients, 50 patients underwent laparotomy wound closure by single layer closure technique and the rest 50 patients by conventional layered closure technique. Time taken for closure of laparotomy wound was noted and patients were followed up post-operatively for any wound complications like seroma, wound infection, wound gaping, burst abdomen and incisional hernia. RESULTS: The mean time taken for closure of laparotomy wounds by single layer closure technique was 19 minutes and by conventional layered closure technique was 27 minutes. There was a difference of 8 minutes which was statistically significant (p=0.001). In the postoperative period, in patients who underwent single layer closure, totally 9 patients (18%) had post operative complications. In that 3 patients (6%) had seroma, 3 patients (6%) had wound infection, 2 patients (4%) had wound gaping, 1 patient (2%) had burst abdomen and none had incisional hernia. In patients who underwent conventional layered closure, totally 15 patients (30%) had post operative complications. In that 5 patients (10%) had seroma, 4 patients (8%) had wound infection, 3 patients (6%) had wound gaping, 2 patients (4%) had burst abdomen and 1 patient (2%) had incisional hernia. CONCLUSION: Laparotomy wound closure with single layer closure technique is better than the conventional layered closure technique in terms of decreased operative time and also decreased postoperative complications.