POLYDIOXANONE VERSUS POLYPROPYLENE CLOSURE FOR MIDLINE ABDOMINAL INCISIONS

Authors

  • Samina Naz Department of Surgery Unit II, Federal Government Services Hospital, Islamabad
  • Sohail Ahmed Memon Liaquat University of Medical & Health Sciences, Jamshoro
  • Mansoor Ali Jamali Pakistan Institute of Medical Sciences (PIMS), Islamabad
  • Muhammad Rashid Ahmed Baqai Medical University, Karachi
  • Tahmida Almani Baqai Medical University, Karach

Abstract

Background: Midline laparotomy is the most common technique of abdominal incisions because it is simple, provides adequate exposure to all four quadrants, and is rapid to open. A major problem after midline laparotomy remains the adequate technique of abdominal fascia closure. This study was conducted to see the role of Polydioxanone and Prolene for midline abdominal closure in terms of postoperative wound infection and wound pain. Methods: This study was carried out at surgical unit II, Federal Government Services Hospital Islamabad. Patients were equally divided in two groups, i.e., A and B. Groups A and B patients undergone midline abdominal closure with Polydioxanone number 1 and Polypropylene number 1 sutures respectively. Results: Total 620 patients were included in this study. Post-operative wound pain score according to Visual analogue scale (VAS) was compared in terms of no pain (0), mild pain (1–3), moderate pain (4–6), severe pain (7–9). In group A (Polydioxanone), the frequency and percentages of no, mild, moderate and severe pain were 101 (32.6%), 95 (30.6%), 81 (26.1%) and 33 (10.6%) respectively, where as in group B (polypropylene) it was 82 (26.5%), 43 (13.9%), 59 (19%) and 126 (40.6%) respectively. Similarly, the frequency and percentages of post-operative wound infection in group A (Polydioxanone) and group B (polypropylene) was 105 (33.9%) and 208 (67.1%) respectively. Conclusion: Polydioxanone results in less wound pain and wound infection when compared to Polypropylene.Keywords: Abdominal wound closure; Midline laparotomy; Wound pain; Wound infection

Author Biographies

Samina Naz, Department of Surgery Unit II, Federal Government Services Hospital, Islamabad

Department of Surgery  

Sohail Ahmed Memon, Liaquat University of Medical & Health Sciences, Jamshoro

Departmnet of SurgeryAssistant Professor 

Mansoor Ali Jamali, Pakistan Institute of Medical Sciences (PIMS), Islamabad

Department of Plastic and reconstructive  Surgery

Muhammad Rashid Ahmed, Baqai Medical University, Karachi

Department of Anatomy, Assistant Professor

Tahmida Almani, Baqai Medical University, Karach

Departmet of Obstetrics & Gynecology, Resident

References

Knaebel HP, Koch M, Sauerland S, Diener MK, Buchler MW, Seiler CM. Interrupted or continuous slowly absorbable sutures – Design of a multi-centre randomized trial to evaluate abdominal closure techniques INSECT-Trial [ISRCTN24023541]. BMC Surg 2005;5:3.

Ceydeli A, Rucinski J, Wise L. Finding the Best Abdominal Closure: An Evidence-based Review of the literature. Curr Surg 2005;62(2):220–5.

Fischer L, Baumann P, Hüsing J, Seidlmayer C, Albertsmeier M, Franck A, et al. A historically controlled, single-arm, multi-centre, prospective trial to evaluate the safety and efficacy of MonoMax® suture material for abdominal wall closure after primary midline laparotomy. ISSAAC-Trial [NCT005725079]. BMC Surg 2008;8:12.

Weiland DE, Bay RC, Del Sordi S. Choosing the best abdominal closure by meta-analysis. Am J Surg 1998;176(6):666–70.

Gaikwad V, Kapoor R, Thambudorai R. An ideal suture for midline closure? Indian J surg 2009;71(3):128–32.

Pavlidis TE, Galatianos IN, Papaziogas BT, Lazaridis CN, Atmatzidis KS, Makris JG, et al. Complete dehiscence of the abdominal wound and incriminating factors. Eur J Surg 2001;167(5):351–4.

Rucinski J, Margolis M, Panagopoulos G, Wise L. Closure of the abdominal midline fascia: meta-analysis delineates the optimal technique. Am Surg 2001;67(5):421–6.

Leaper DJ, Pollock AV, Evans M. Abdominal wound closure: a trial of nylon, polyglycolic acid and steel sutures. Br J Surg 1977;64(8):603–6.

Gys T, Hubens A. A prospective comparative clinical study between monofilament absorbable and non-absorb-able sutures for abdominal wall closure. Acta Chir Belg 1989;89(5):265–70.

Korenkov M, Sauerland S, Arndt M, Bograd L, Neugebauer EA, Troidl H. Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia. Br J Surg 2002;89(1):50–6.

Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: a meta-analysis. Ann Surg 2000;231(3):436–42.

van’t Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J. Meta-analysis of techniques for closure of midline abdominal incisions. Br J Surg 2002;89(11):1350–6.

Pandey S, Singh M, Singh K, Sandhu S. A prospective randomized study comparing non-absorbable polypropylene (Prolene®) and delayed absorbable polyglactin 910 (Vicryl®) suture material in mass closure of vertical laparotomy wounds. Indian J Surg 2013;75(4):306–10.

Carlson MA, Condon RE. Polyglyconate (Maxon) versus nylon suture in midline abdominal incision closure: a prospective randomized trial. Am Surg 1995;61(11):980–3.

Chalya PL, Massinde AN, Kihunrwa A, Mabula JB. Abdominal fascia closure following elective midline laparotomy: a surgical experience at a tertiary care hospital in Tanzania. BMC Res Notes 2015;8(1):281.

Van't Riet M, Steyerberg EW, Nellensteyn J, Bonjer HJ, Jeekel J. Meta‐analysis of techniques for closure of midline abdominal incisions. British journal of surgery. 2002 Nov 1;89(11):1350-6.

Sahlin S, Ahlberg J, Granström L, Ljungström KG. Monofilament versus multifilament absorbable sutures for abdominal closure. Br J Surg 1993;80(3):322–4.

Leaper DJ, Allan A, May RE, Corfield AP, Kennedy RH. Abdominal wound closure: a controlled trial of polyamide (nylon) and polydioxanone suture (PDS). Ann R Coll Surg Engl 1985;67(5):273–5.

Bucknall TE, Teare L, Ellis H. The choice of a suture to close abdominal incisions. Eur Surg Res 1983;15(2):59–66.

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Published

2017-10-15