Polypropylene Versus Polydioxanone Sutures for Fascial Closure in Emergency Midline Laparotomy: A Retrospective...

Area of Science:

• Abdominal surgery
• Surgical wound healing
• Biomaterials in surgery

Background:

• Emergency midline laparotomy carries a high risk of postoperative wound complications.
• Optimal fascial closure is crucial, especially in contaminated settings where mesh is not feasible.
• Limited comparative data exists for polypropylene versus polydioxanone (PDO) sutures in this context.

Purpose of the Study:

• To compare postoperative wound outcomes and operative parameters between polypropylene and PDO sutures.
• To evaluate the incidence of burst abdomen, surgical site infection, and incisional hernia.
• To identify predictors of incisional hernia after emergency laparotomy.

Main Methods:

• Retrospective observational study of 80 adult patients undergoing emergency midline laparotomy.
• 40 patients received polypropylene sutures, and 40 received PDO sutures.
• Outcomes assessed included wound complications, operative duration, and hospital stay; logistic regression was used for analysis.

Main Results:

• PDO group had significantly lower rates of burst abdomen (2.5% vs 7.5%), surgical site infection (10% vs 17.5%), and incisional hernia (5% vs 10%) compared to polypropylene (p<0.05).
• PDO group also showed shorter skin closure time, operative duration, and hospital stay.
• Wound contamination was the sole independent predictor of incisional hernia (aOR 4.76; p=0.048).

Conclusions:

• PDO sutures were associated with fewer wound complications than polypropylene in this retrospective emergency laparotomy cohort.
• Wound contamination, not suture material, independently predicted incisional hernia.
• Further prospective studies are needed to validate these findings due to study limitations.