A randomised control trial comparison the efficacy between delayed-absorbable polydioxanone and non-absorbable suture material in abdominal wound closure
DOI:
https://doi.org/10.18203/2349-2902.isj20164079Keywords:
Abdominal wound dehiscence, Burst abdomen, Suture sinus, Wound infection, X suture techniqueAbstract
Background:The objective of this study was to compare polydioxanone (PDS) and polypropylene (PPL) suture material for fascial closure in midline abdominal incisions using interrupted X sutures in terms of post - operative wound complications.
Methods: Patients for clinical study were selected from the surgical wards of Chigateri District Hospital and Bapuji Hospital, Davangere, India with the following inclusion and exclusion criteria. A minimum of 50 cases of randomized midline laparotomy incisions were studied, after informed consent to either a polydiaxanone (PDS) or polypropylene (PPL) suture material. Equal numbers of cases were studied for closure with these two suture materials. The patients were followed-up 01, 02 weeks and then one month after surgery.
Results:People around 36-45 years age group formed the maximum numbers in this study. Male to female ratio was 1.94:1. There was one burst abdomen (out of 25 cases, 4%) in polypropylene group and none (out of 25 cases) in polydiaxanone group. Incidence of wound infection was 12% (6 out of 25 cases) in polypropylene group compared to 6% (3 out of 25 cases) in polydiaxanone group. The relative risk of wound infection was 0.50. The complications like burst abdomen, wound infection and suture sinus incidence of suture sinus was 12% (3 out of 25 cases) in polypropylene group as compared to 4% (1 out of 25 cases) in polydiaxanone group. Infection rate was 12% (6 cases) in polypropylene group and 6% (3 cases) in polydiaxanone group.
Conclusions:Hence interrupted X suture technique using polydiaxanone (PDS) for closure of midline laparotomy incision, is superior to polypropylene (PPL) suture material. Also PDS is superior in preventing major post-operative wound.
Metrics
References
Orr JW, Orr PF, Barret JM. Continuous or interrupted fascial closure: a prospective evaluation of no. 1 Maxon suture in 402 gynecologic procedures. Am J Obstet Gynecol. 1990;163:1485-89.
Chana RS, Sexena YC, Agarwal A. A prospective study of closure technique. Indian Med Assoc. 1980;88:359-69.
Carlson MA. Acute wound failure. Surg Clin North Am. 1997;77:607-36.
Shukla HS, Kumar S, Misra MC, Naithani YP. Burst abdomen and suture material: a comparison of abdominal wound closure with monofilament nylon and chromic catgut. Indian J Surg. 1981;43:487-91.
Dudley HAF. Layered and mass closure of the abdominal wall. Br J Surg. 1970;57:664-7.
Jenkins TPN. The burst abdominal wound: a mechanical approach. Br J Surg. 1976;63:873-6.
Jones TE, Newelle ET, Brubaker RE. The use of alloy steel wire in closure of the abdominal wounds. Surg Gynaecol Obstet. 1941;72:1056-9.
Srivastava A, Roy S, Shaya KB, Kumar A, Chumbar S, et al. Prevention of burst abdominal wound by a new technique: a randomized trial comparing continuous versus interrupted X sutures. Ind J Surg. 2004;66:19-27.
Niggebrugge AH, HansenBE, Trimbos JB, Velde CJ, Zwaveling A, Mechnical Factors influencing the incidence of burst abdomen. Eur J Surg. 1995;161:655-61.
Russel RCG, Norman SW, Christopher JKB. Basic surgical skills and anastomoses. In: Bailey and love's Short practice of surgery. London:Arnold Hodder. 2008:237-238.
Niggebrugge AHP, Trimbos JB, Hermans J, Knippenberg B, Velde CJHVD. Continuous double loop closure: a new technique for repair of laparotomy wound. Br J Surg. 1997;84:258-61.
Israelsson LA, Jonsson T. Suture length to wound length ratio and healing of midline laparotomy incisions. Br J Surg. 1993;80:1284-6.
Downloads
Published
How to Cite
Issue
Section
