Interrupted or Continuous Slowly Absorbable Sutures For Closure of Primary Elective Midline Abdominal Incisions

• DOI: 10.1097/sla.0b013e31819ec6c8
• Publication Date: 2009-05-21T10:15:26Z
• Authors: Christoph M. Seiler; Thomas Bruckner; Markus K. Diener; Armine Papyan; Henriette Golcher; Christoph Seidlmayer; Annette Franck; Meinhard Kieser; Markus W. Büchler; Hanns-Peter Knaebel
• Keywords: Polydioxanone; Vicryl; Clinical endpoint; Incisional Hernia; Barbed suture

In Brief Objective: patients undergoing midline incisions, the abdominal fascia can be closed with a continuous or interrupted suture using various materials. The aim of this study is to compare: (1) technique rapidly absorbable sutures and (2) techniques different slowly sutures, focusing on incidence incisional hernias within 1 year. Summary Background Data: A meta-analysis suggested that more effectively reduced sutures. Methods: Multicenter randomized surgical trial 3 parallel groups. Patients were scheduled for primary elective incisions. All surgeons trained (4:1 wound length in groups) monitored. Primary end point, measured year after surgery, was frequency diagnosed by clinical examination confirmed ultrasound. Complications safety used as secondary points. This has been registered ISRCTN Register (INSECT: ISRCTN24023541). Results: Conducted 625 (210 Vicryl, 205 polydioxanone (PDS), 210 Monoplus), analysis showed an 28 (15.9%) versus 15 (8.4%) 22 (12.5%) closure techniques, respectively (P = 0.09). No significant difference observed between groups regard burst abdomen (4 [2.0%] vs. 6 [3.0%] 8 [4.0%], P 0.46), infection (26 [12.7%] 39 [19.4%] 33 [16.3%], 0.19), pulmonary infections (9 [4.4%] 5 [2.5%] [2.5%], serious adverse events (63 [30.0%] 57 [27.8%] 61 [29.1%], 0.89), 1-year mortality (16 [7.9%] 11 [5.5%] 16 [7.9%], 0.54). Conclusions: higher than expected all New concepts need developed studied substantially reduce hernias. multicenter comparing incisions did not demonstrate these respect year, abdomen, infections, postoperative complications, overall safety, including mortality.