Study of Different Methods of Midline Laparotomy Incision Closure and their Outcomes


Dinesh Joshi
Nikunj Varandani
Mandar Vaidya


Background: The closure of such a laparotomy wound is important to minimize the postoperative complications like wound pain, infection, dehiscence and incisional hernia. Aims: The objectives of this study was to study the various techniques of midline laparotomy incision closure and their outcomes like wound dehiscence, wound infection and incisional hernia up to six months. Materials and Methods: A total of 100 patients who were operated for midline laparotomy were included as subject material after they satisfied the inclusion and exclusion criteria. Results: Most common indication of laparotomy in the study was gastric ulcer perforation. Incidence rate of surgical site infection, wound dehiscence and incisional hernia was lower in cases of smaller bite length. Incidence rate of surgical site infection wound dehiscence and incisional hernia was lower with continuous suturing. Conclusion: The study results showed that best technique for midline laparotomy incision closure is small bite continuous suturing with mass closure. The small bites technique with continuous suturing showed better results than small bite technique with interrupted suturing. Present study thus recommends that small bite continuous suturing with mass closure should be considered as the standard closure technique for midline incisions.


How to Cite
Joshi, D. ., Varandani, N. ., & Vaidya, M. . (2022). Study of Different Methods of Midline Laparotomy Incision Closure and their Outcomes. MVP Journal of Medical Sciences, 249–252.


  1. Ellis H. Midline abdominal incision. Br J Obstet Gynecol. 1984; 91:1-2. PMid:6229270. DOI:
  2. Sutton G, Morgan S. Abdominal wound closure using a running, looped Monofilament polybutester suture: Comparison to Smead-Jones Closure in Historic Controls. Obstet Gynecol. 1992; 80(4):650-654.
  3. Gandhi JA, Shinde PH, Digarse RD. Evaluation of abdominal wall closure technique in emergency laparotomies at a tertiary care hospital. Int Surg J. 2016; 3:1796-1801. DOI:
  4. Mahey R, Ghetla S, Rajpurohit J, Desai D, Suryawanshi S. A prospective study of risk factors for abdominal wound dehiscence. Int Surg J. 2017; 4:24-28. DOI:
  5. Gislason H, Viste A. Closure of burst abdomen after major gastrointestinal operations-comparison of different surgical techniques and later development of incisional hernia. Eur J Surg. 1999; 165:958-961. PMid:10574104. DOI:
  6. Varghese F, Gamalial J, Kurien JS. Skin stapler versus sutures in abdominal wound closure. Int Surg J. 2017; 4:3062-3066. DOI:
  7. Inamdar MF, Singh AR, Inamdar NM. Incisional hernia: risk factors, clinical presentations, and pre-peritoneal polypropylene mesh repair. Int Surg J. 2017; 4:1189-1194. DOI:
  8. Deshmukh SN, Maske AN. Mass closure versus layered closure of midline laparotomy incisions: A prospective comparative study. Int Surg J. 2018; 5:584-587. DOI:
  9. Diener MK, Voss S, Jensen K, Büchler MW, Seiler CM. Elective midline laparotomy closure: the INLINE systematic review and meta-analysis. Ann Surg. 2010; 251(5):843. PMid:20395846 DOI: