Compression suture of the abdominal wall: a controlled trial in 302 major laparotomies

Monofilament nylon suture material undergoes both plastic and elastic elongation when stretched. Nylon inserted as a continuous suture for approximation of the abdominal musculo-aponeurosis may, therefore, allow early separation of the cut edges, which may predispose to the later development of an incisional hernia. This hypothesis was tested in a consecutive series of 302 major laparotomies randomized to be sutured with continuous mass nylon either to approximate or to compress the deep layers. The incidence of incisional hernia at 6 months in the group sutured with normal tension was 10.0 per cent, compared with 5.5 per cent in those tightly sutured. There was, however, an increased rate of minor wound infection in the latter group.