Mass closure versus layer closure of abdominal wound: a prospective clinical study

The results of a controlled clinical trial of two currently recommended methods of abdominal closure have been reported here. OUt of 160 patients, 80 cases were randomised to have their abdominal wall closed in single layer mass closure with monofilament nylon and 80 cases in layer closure with chromic catgut. Eighteen patients (22.5%) in the former and 38 (47.5%) in the latter had wound infection (p < 0.001). Sinus formation occurred in 2 patients (2.5%) in the mass and 20 (25%) in the layered group (p < 0.001). Three cases (3.75%) of burst abdomen occurred in layer closure and none in mass closure. Wound infection was the most important denominator next to suture material influencing wound healing. There was a significant association between the rate of infection and sinus formation. Minimal complication and good patient compliance seem to justify the use of mass closure in place of layer closure in all types of abdominal operations.