Incisional closure in morbidly obese patients

Wound complications cause significant morbidity in patients undergoing gastric restrictive procedures. Two randomized, prospective trials were done evaluating suture technique and material. A subcutaneous suction catheter was used for 48 hours in all patients. In Trial I a Polyglactin-910 (Vicryl) suture, #1 in size, was used. Patients were randomized between interrupted Smead-Jones far-far-near-near sutures and running sutures. Because hernia formation appeared excessive in both groups of patients, a second study was done comparing running #1 polydioxanone (PDS) and #1 polypropylene (Prolene) suture. Hernia formation was excessive in this group as well. The authors conclude running and interrupted closures are of equal reliability. Hernia formation was excessive in both groups. The type of suture material used in these studies was inconsequential. A better method of closure is needed in morbidly obese patients to achieve less postoperative hernia formation.