CLOSURE OF ELECTIVE ABDOMINAL INCISIONS WITH MONOFILAMENT, NON-ABSORBABLE SUTURE MATERIAL VERSUS POLYFILAMENT ABSORBABLE SUTURE MATERIAL
Abstract
Background: Closure of abdominal incisions with different suture materials has been a matter of greatcontroversy. 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
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.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
