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Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure.

A Bloemen¹, P van Dooren, B F Huizinga

¹Department of General Surgery, Orbis Medical Centre, PO Box 5500, 6130 MB Sittard, The Netherlands.

The British Journal of Surgery

|January 22, 2011

Summary

This study found no significant difference in incisional hernia rates between non-absorbable polypropylene (Prolene®) and absorbable polydioxanone (PDS®) sutures for abdominal fascia closure. Both suture types resulted in higher than expected hernia rates.

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Area of Science:

Surgical innovation
Clinical research
Abdominal surgery

Background:

Incisional hernia is a common complication following abdominal surgery.
Surgical intervention is often necessary for treatment.
This study investigated suture materials for fascial closure.

Purpose of the Study:

To compare the efficacy of non-absorbable polypropylene (Prolene®) versus absorbable polydioxanone (PDS®) suture materials in preventing incisional hernias.
To assess secondary outcomes including surgical-site infection and suture sinus formation.

Main Methods:

A prospective randomized trial involving 456 patients undergoing abdominal surgery.
Fascial closure was performed using either Prolene® or PDS® sutures.
Follow-up included clinical examination and ultrasonography at 6-month intervals.

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Main Results:

Incisional hernia incidence was 20.2% with Prolene® (n=223) and 24.9% with PDS® (n=233), a non-significant difference (P=0.229).
Four-year cumulative hernia rates were 23.7% for Prolene® and 30.2% for PDS® (P=0.222).
No significant differences were observed in secondary outcomes like surgical-site infection or suture sinus.

Conclusions:

Both polypropylene (Prolene®) and polydioxanone (PDS®) sutures demonstrated comparable outcomes regarding incisional hernia formation.
The incidence of incisional hernias observed in this trial exceeded expectations based on prior literature.
Current evidence suggests no significant difference between these two suture materials for abdominal fascia closure.