Which suture is ideal for abdominal fascial closure: polydioxanone or polypropylene?

Abstract

Background: A secured fascial closure with appropriate suture material is an integral step to prevent complications in laparotomy. A costly post-operative complication is wound dehiscence which manifests as incisional hernia as a delayed complication. The present study compared prolene and polydioxanone (PDS) sutures in patients undergoing midline closure after emergency exploratory laparotomy with the aim to evaluate wound outcome after the use of either of the sutures. Methods: Sixty-six patients undergoing emergency laparotomy were randomly divided into two groups: group A (PDS) and B (prolene). Wound complications were evaluated for each patient in terms of wound pain, wound discharge, burst abdomen, stitch sinus, stitch granuloma and incisional hernia. Results: Wound pain was observed more in prolene group, p<0.05 till 3rd post-op day. Wound discharge, wound dehiscence and burst abdomen were more in prolene group, but the difference was statistically insignificant (p>0.05). Six patients developed incisional hernia, out of which 5 had prolene, (p>0.05). Similar statistically insignificant difference was found with stitch granuloma and stitch sinus. Conclusions: Till date there is lack of agreement about the ideal suture for abdominal fascial closure. Present study concluded that any suture material is equally effective for abdominal fascial closure since there are many other factors contributing towards wound complications.