A randomized clinical trial comparing two methods of fascia closure following midline laparotomy

Arch Surg. 1992 Oct;127(10):1232-4. doi: 10.1001/archsurg.1992.01420100094016.

Abstract

Three hundred forty women undergoing midline laparotomy were randomized into an interrupted suture (polyglactin 910, size 1) or a continuous suture (polyglyconate, size 0) closure group. The two groups were well balanced with respect to various risk factors for postoperative wound complications. Early evaluation revealed no differences between the continuous and interrupted suture groups with respect to wound infection (3% vs 1%), superficial wound dehiscence (2% vs 4%), and deep wound dehiscence (0.6% vs 0%). Late evaluation showed no differences between the two groups either. Continuous polyglyconate and interrupted polyglactin 910 sutures had a similar incidence of suture fistula (0% vs 2%), wound pain (1% vs 2%), and incisional hernia (3% vs 4%). Continuous closure was done faster and resulted in less foreign-body suture material. Despite its smaller diameter, the polyglyconate suture also retains a higher tensile strength after surgery than does the quicker-degrading polyglactin 910 suture. Results of this study lead to the conclusion that a running polyglyconate suture is the better choice for closure of the abdominal-wall fascia following midline laparotomy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdominal Muscles / surgery*
  • Fasciotomy*
  • Female
  • Fistula / etiology
  • Follow-Up Studies
  • Hernia / etiology
  • Humans
  • Laparotomy / methods*
  • Middle Aged
  • Pain, Postoperative / etiology
  • Polyglactin 910* / adverse effects
  • Polyglactin 910* / chemistry
  • Polymers* / adverse effects
  • Polymers* / chemistry
  • Risk Factors
  • Skin Diseases / etiology
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / etiology
  • Suture Techniques* / adverse effects
  • Sutures* / adverse effects

Substances

  • Polymers
  • Polyglactin 910
  • polyglyconate