Single versus two layer suturing for wound closure after inguinal hernia repair.

OBJECTIVE: Method of skin-subcutaneous closure after inguinal herniorrhaphy affects the operation time and immediate outcome of the wound. The study was aimed to assess the effects of a single layer closure of the skin and subcutaneous wound of inguinal herniorrhaphy, in contrast to the conventional two layer closure. DESIGN: Prospective randomized controlled trials. SETTING: Obafemi Awolowo University Teaching Hospital Ile-Ife, Osun State, Nigeria. PATIENTS AND METHOD: All adult patients attending surgical out patient clinic with uncomplicated inguinal hernia and had surgery, after randomization into two groups from June 2000 Dec 2005 were included in the study. One group had one layer - closure i.e. closure of skin and subcutaneous tissues together at once while the second group had two layer closure i.e. closure of skin and subcutaneous tissues separately. Duration of operation and complications were documented for comparison. RESULTS: One hundred and eighty wounds were studied in 160 patients; the extra wounds being from bilateral inguinal hernias. There were 93 wounds in group one (two layer closure) and 87 wounds in group two (one layer closure. There was no significant difference between healing of wounds and appearance of scars in both groups. The single layer closure group was, however, apparently quicker. (P= 0.006). CONCLUSION: The immediate outcome of the wound in both groups was similar. The medical personnel time was saved by closing the wound in single layer.