Layer closure of laparotomy wounds with absorbable and non-absorbable suture materials

Opinions vary regarding the best suture material for abdominal wound closure. Some surgeons favour non-absorbable sutures while others use absorbable materials, but there is little objective clinical information regarding the relative merits of the different suture materials. In a randomized prospective clinical trial the synthetic absorbable polyglactin and polyglycolic acid sutures were compared with the non-absorbable polypropylene suture in the closure of 161 laparotomy wounds. A layered closure technique was used in all cases. The total incidence of wound dehiscence and herniation was 8-1 per cent, and there was no significant difference between polylycolic acid (9-6 per cent), polyglactin (5-8 per cent) and polypropylene (8-8 per cent). Dehiscence and herniation were significantly more common in wounds closed by surgeons in training. It was concluded that none of the suture materials provided satisfactory freedom from wound complications. It is possible that these sutures may prove satisfactory with an alternative technique of abdominal wound closure, but this should be the subject of further clinical studies.