Objective To investigate the effect of a new suturing method called two-layer closure and to compare this with the traditional four-layer suturing method. Methods A randomized controlled trial was conducted in patients admitted from January to April 2008. A total of 124 eligible patients were divided into 2 groups. Sixty-one patients in the trial group received two-layer closure, while 63 in the control group received four-layer closure. The baseline conditions before the operation, incision parameters, and the recovery of the body and incision after the operation were compared between the 2 treatment groups. Results The baseline characteristics of the groups were similar. No significant differences were observed in terms of the length of hospital stay, time to food intake, time to ground activity, and time to first passage of gas by anus (Pgt;0.05). However, the incidence of fever after the operation was significantly lower in the trial group compared with the control group (P=0.014). The healing level of the incisions was comparable between the 2 groups (Pgt;0.05). As for complications after the operation, no cases of incision infection or incision granuloma or sinus tract were reported. However, 3 cases of active hemorrhage and 2 cases of incision split occurred in the control group. Moreover, the incidence of incision liquefaction in the trial group was significantly lower than that in the control group (P=0.03). Conclusion For abdominal median incision, two-layer closure is associated with smaller incision trauma, less stimulation from extraneous materials, as well as more accurate anatomic replacement compared with the traditional four-layer closure. However, further studies need to be conducted to determine whether the new suturing method of twolayer closure is effective and safe for other kinds of incision.