An ideal suture for midline abdominal closure?
Vinay Gaikwad1, Rajeev Kapoor, Robin Thambudorai
1Department of Surgery, Christian Medical College and Hospital, Ludhiana, 141 008 Punjab India.
The Indian Journal of Surgery
|November 8, 2012
Summary
This study found that slowly absorbable Polydioxanone sutures led to a higher incidence of wound dehiscence compared to non-absorbable Nylon for midline abdominal closure. Therefore, Polydioxanone is not recommended for this surgical application.
Area of Science:
- Surgical innovation and wound closure techniques.
- Comparative analysis of suture materials in abdominal surgery.
Background:
- Shift towards slowly absorbable sutures for abdominal closure due to perceived lower complication rates.
- Non-absorbable Nylon and slowly absorbable Polydioxanone (PDS) are widely used suture materials.
Purpose of the Study:
- To compare the efficacy and safety of Nylon versus Polydioxanone for midline abdominal closure in the Indian population.
- Evaluate wound strength and complication incidence between the two suture types.
Main Methods:
- Randomized clinical trial involving 64 patients undergoing midline laparotomy.
- Patients were randomized to receive continuous closure with either Polyamide (Nylon) or Polydioxanone (PDS).
Main Results:
- Significantly higher incidence of wound dehiscence in the Polydioxanone group (5 cases) compared to the Nylon group (0 cases).
- The study was prematurely stopped due to high dehiscence rates in the PDS group.
- Higher incidence of scar pain was observed in the Nylon group (9 cases) versus the PDS group (1 case).
Conclusions:
- Polydioxanone (PDS) is not recommended as a suture of choice for midline abdominal wound closure.
- Further studies with larger patient cohorts are needed to fully elucidate suture material performance.
