Comparing clinical outcomes between patients receiving non-absorbable and delayed absorbable sutures for abdominal wound closure after laparotomy

Authors

  • Rabin Pratap Shah Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal
  • Lakhan Lal Sah Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal
  • Rakesh Kumar Pandit Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal

DOI:

https://doi.org/10.18203/2349-2902.isj20232321

Keywords:

Suture, Surgical site infection, Post-operative complications

Abstract

Background: There is a lot of debate about the best suture for repairing the abdominal fascia post-laparotomy. This research compared the clinical results of patients who received non-absorbable versus delayed absorbable sutures for abdominal wound closure after laparotomy.

Methods: We conducted a prospective non-randomized clinical trial in the Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal. We included patients aged more than 18 years who underwent an elective laparotomy surgery with midline vertical incision for any indication between April 2020 till March 2022 in our department. Two study groups were formed: non-absorbable suture (polypropylene suture) and delayed absorbable suture (polydiaxanone suture).

Results: The two study groups were similar with respect to indication of surgery (p value = 0.52). Bowel was opened in 81% in non-absorbable group and in 85% in delayed absorbable suture group. Mean duration of surgery was found to be significantly lower in the delayed absorbable suture group as compared to non-absorbable suture group (185±21.8 vs. 232±27.3 minutes, p value < 0.05). Post-operative complications included surgical site infection, burst abdomen, incisional hernia and sinus formation. It was observed that surgical site infection rate was significantly higher among non-absorbable suture group patients as compared to delayed absorbable suture group (25% vs. 13%, p value <0.05).

Conclusions: Comparing early and late post-operative complications, there was no statistically significant difference between non-absorbable suture group and delayed absorbable suture group.

References

Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(2):S66-88.

Rajapandian S, Bhushan C, Sabnis SC, Jain M, Raj PP, Parathasarthi R, et al. Single incision multiport versus conventional laparoscopic inguinal hernia repair: A matched comparison. J Minimal Access Surg. 2018;14(1):44.

Giordano S, Garvey PB, Baumann DP, Liu J, Butler CE. Primary fascial closure with biologic mesh reinforcement results in lesser complication and recurrence rates than bridged biologic mesh repair for abdominal wall reconstruction: A propensity score analysis. Surgery. 2017;161(2):499-508.

Spotnitz WD, Falstrom JK, Rodeheaver GT. The role of sutures and fibrin sealant in wound healing. Surg Clin. 1997;77(3):651-69.

Limura E, Giordano P. Biological implant for complex abdominal wall reconstruction: a single institution experience and review of literature. World J Surg. 2017;41(10):2492-501.

Hodgson NCF, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure. A meta analysis. Ann Surg. 2000;231(3):436-42.

Niggebrugge AHP, Trimbos JB, Hermans J, Knippenberg B, Velde CJ. Continuous double loop closure: a new technique for repair of laparotomy wound. Br J Surg. 1997;84:258-61.

Pai D, Shenoy R, Chethan K. Comparison of non-absorbable (polypropylene) versus delayed absorbable (polydioxanone) suture material for abdominal wound closure after laparotomy. Int Surg J. 2018;5:1690-6.

Kailas CT, Naik CG. A randomised control trial comparison the efficacy between delayed-absorbable polydioxanone and non- absorbable suture material in abdominal wound closure. Int Surg J. 2017;4:153-6.

Ranjan R, Bharti N. Comparative study of non-absorbable versus delayed absorbable suture material and suturing technique in midline abdominal closure. Int J Health Clin Res. 2021;4(1):47-9.

Kadiya K, Meman A. Comparative study between delayed absorbable and non-absorbable sutures in cases of abdominal fascia closure for laparotomy. Indian J Res. 2021;10(10):1-2.

Chalya P, Massinde A, Kihunrwa A, Mabula J. Abdominal fascia closure following elective midline laparotomy: a surgical experience at a tertiary care hospital in Tanzania. BMC Res. 2015;8(1):45-9.

Agrawal V, Sharma N, Joshi M, Minocha V. Role of suture material and technique of closure in wound outcome following laparotomy for peritonitis. Trop Gastroenterol. 2009;30(4):237-40.

Bucknall T, Ellis H. Abdominal wound closure-a comparison of monofilament nylon and polyglycolic acid. Surg. 1981;89(6):672-7.

Downloads

Published

2023-07-28

Issue

Section

Original Research Articles