Background: Effective rectus sheath closure is crucial in laparotomy to prevent complications like wound dehiscence and incisional hernia. Purpose: This study compares conventional continuous suturing with modified Smead Jones continuous and intermittent techniques to determine the optimal method for reducing complications. Methods: A prospective, randomized study was conducted at a tertiary care centre with patients undergoing midline laparotomy. Participants were assigned to one of three suturing techniques. Postoperative complications, including wound dehiscence, incisional hernia, and surgical site infections, were assessed. Results: The modified Smead Jones intermittent technique had the lowest complication rates, with wound dehiscence at 2% and incisional hernia at 3%, followed by modified Smead Jones continuous suturing (3% and 5%) and conventional continuous suturing (6% and 8%). Surgical site infection rates were comparable across groups. Conclusion: Modified Smead Jones suturing, particularly the intermittent method, provides superior wound stability and fewer complications. Its adoption in high-risk patients could enhance postoperative outcomes.

Laparotomy, Suturing Techniques, Wound Dehiscence, Incisional Hernia, Modified Smead Jones, Continuous Suturing, Intermittent Suturing, Postoperative Complications.