Randomized Comparison of Nylon Versus Absorbing Polyglactin 910 for Fascial Closure in Caesarean Section

Abstract

Background:Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material.Objectives:The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean.Patients and Methods:This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ≤ 0.05 was considered as statistically significant.Results:One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically significant difference in wound stitch and incision hernia was demonstrated between the suture groups.Conclusions:The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.

Skin and subcutaneous fascia closure at caesarean section to reduce wound complications: the closure randomised trial

“…We have shown that there is some weak evidence to suggest that the combined intervention of subcutaneous fascia closure and skin suturing with absorbable monofilament suture (Caprosyn™), is associated with an increased risk of postoperative wound infection, in comparison with subcutaneous fascia closure and skin suturing with non-absorbable monofilament suture (Prolene™). While previous studies have shown no statistically significant difference in wound infection rates when comparing the use of absorbable versus non-absorbable skin sutures [ 26 – 28 ], the combination of subcutaneous fascia closure (or non-closure) with different skin sutures has not been considered.…”

The Case for Standardizing Cesarean Delivery Technique

“…One RCT addressing suture type (nonabsorbable compared with delayed-absorbable) has been performed since the previous review, demonstrating less chronic incisional pain with delayed-absorbable suture. 4 , 73 …”

The Effect of Absorbable and Non-Absorbable Sutures on Nasal Width Following Cinch Sutures in Orthognathic Surgery

“…However, the irritation caused by non-absorbable materials over the subnasale and alar base is often complained about after the surgery. Kolsoum et al reported that subjects sutured with PDS were less likely to experience chronic incision pain and wound stitches, compared to nylon [22]. Durmaz et al concluded that absorbable sutures may be preferred in the nasal cavity because of their ease of use, and non-absorbable sutures have the disadvantage of feeling discomfort [23].…”