CLOSURE OF ELECTIVE ABDOMINAL INCISIONS WITH MONOFILAMENT, NON-ABSORBABLE SUTURE MATERIAL VERSUS POLYFILAMENT ABSORBABLE SUTURE MATERIAL

Altaf Ahmed Talpur, Mohammad Sharif Awan, Abdul Rasheed Surhio

Abstract


Background: Closure of abdominal incisions with different suture materials has been a matter of great
controversy. Polypropylene and Polylactide with Polyglycolide are among the commonest suture
materials used for closure of abdominal incisions. Objectives of this study were to assess optimal suture
material used for closure of elective abdominal incisions and to see complications associated with these
suture materials. Methods: This prospective, comparative, randomised study was conducted at public
and private sector hospitals of Nawabshah and Hyderabad from 1st Jan 2005 to 31st October 2009. All
patients who underwent abdominal surgery under the investigators’ supervision were included in the
study. Patients were divided into 2 groups on even or odd numbers. In group-A patients’ incision was
closed with monofilament, non-absorbable Polypropylene (Prolene) No. 1 suture material and in groupB incision was closed with Polyfilament, absorbable, co-polymer of Polylactide with Polyglycolide
(Vicryle) No. 1. Results: A total 274 patients were finally analysed for closure of elective abdominal
incisions, with 138 (50.4%) patients in Group-A and 136 (49.6%) patients in Group-B. Vicryle was
found superior in knot security and suture handling. Superficial wound infection was found in 5.79%
patients of Group-A and 6.61% of Group-B. Discharging sinus was found in 3.62% of Group-A vs
0.73% of Group-B. Burst abdomen was seen in 2.17% patients in Group-A and 1.47% in Group-B.
Incisional hernia was present in 4.34% of Group-A and 0.73% patients of Group-B. No patient in
Group-B developed persistent pain at incisional site while it was found in 8.69% patients of Group-A.
Conclusion: Polylactide is an optimal suture material in closure of elective abdominal incisions.
Keywords: elective, incisions, monofilament, polyfilament, suture, postoperative, complications

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References


Conze J, Klinge U, Schumpelick V. Incisional Hernia. Chirurg

;76:897–909.

Leaper DJ, Winslet MC. Basic surgical skills and anastomosis.

In: Bailey and Love’s Short Practice of Surgery. 24th Ed. 2004,

Vol. 1, pp. 98–9, 1186–90.

Kirk RM, Williamson RCN. Laparotomy; elective and

emergency. In: Krik RM, (Ed). General surgical operations, 4th

Ed. Edinburgh: Churchill Livingstone; 2000, 81–6, 89–92.

Johnstone JMS, Rintoul RF. Abdominal surgery: access and

procedures. In: Farquharsons Textbook of Operative Surgery. 8th

Edition. UK: Churchill Livingstone; 1995. p.338–40.

Cusheri A. Disorders of abdominal wall and peritoneal cavity. In:

Cusheri A, Steele RJC, Moosa AB, editors. Essential Surgical

Practice. 4th ed. London: Arnold; 2002. p. 143–82.

Weiland DE, Bay RC, Del Sordi S. Choosing the best abdominal

closure by meta- analysis. Am J Surg 1998;176:666–70.

Rucinski J, Margolis M, Panagopoulos G, Wise L. Closure of

midline abdominal fascia. Meta-analysis delineates the optimal

technique. Am Surg 2001;67(5):421–6.

J Ayub Med Coll Abbottabad 2011;23(2)

http://www.ayubmed.edu.pk/JAMC/23-2/Talpur.pdf

Yahchonchy-Chonillard E, Aura T, Piccone O, Etienne JC,

Fingerhut A. Incisional hernia, Related risk factors. Dig Surg

;20:3–9.

Knaebel HP, Koch M, Sauerland S, Diener MK, Büchler MW,

Seiler CM; INSECT Study Group of the Study Centre of the

German Surgical Society. Interrupted or continuous slowly

absorbable sutures, Multi-centre randomized trial to evaluate

abdominal closure technique INSECT-Trial. BMC Surg

;5:3.

Ceydeli A, Rucinski J, Wise L, Finding the best abdominal

closure: An evidenced-based review of the literature. Curr Surg

;62:220–5.

Van’t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel

J. Meta-Analysis of technique for closure of midline abdominal

incisions. Br J Surg 2002;89:1350–6.

Choudhary SK, Choudhary SD. Mass closure vs. layered closure

of abdominal wound: a prospective clinical study. J Indian Med

Assoc 1994;92:229–32

McLean S, Kreamer B. Wound care and healing. The

Washington manual of Surgery, 3rd Edi. USA: Lippincott

Williams & Wilkins; 2002.p. 176–7.

Hodgson NC, Mathaner RA, Ostbye T. The search for an ideal

method of an abdominal fascia closure, a meta-Analysis. Ann

Surg 2000;231:436–42.

Gys T, Hubens A. A prospective, comparative clinical study

between monofilament absorbable and non-absorbable sutures

for abdominal wall closure. Acta Chir Belg 1989;89:265–70.


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