Publication:

A comparative study of outcome of the absorbable suture polydioxanone and nonabsorbable suture polypropylene in laparotomy wound closure

Background Abdominal wound closure is one of the common operations for a general surgeon. Prevention of complications is important to reduce post-operative morbidity and mortality. Post-operative wound pain, wound infection, wound dehiscence, suture sinus formation; palpable knots and incisional hernia are the parameters are to be studied.  Therefore, the present study was undertaken to compare polydioxanone and polypropylene suture material for abdominal fascial closure regarding morbidity in terms of post-operative wound complications.

Methods Patients admitted in the department of surgery, who undergo laparotomy operations, with midline abdominal incisions were included in the study. The recruited subjects were divided into Group-A, whom abdominal incisions are closed with non-absorbable suture material polypropylene and Group-B whom abdominal incisions are closed with absorbable suture material polydioxanone. Data was expressed as percentages.

Results The incidence of wound pain was observed in all the patients in both immediate and delayed post-operative period in the polypropylene suture material compared to polydioxanone.  The incidence of wound infection was higher in polypropylene (24%) compared to PDS (2%). There were 4% cases of wound dehiscence in the present study. The incidence of suture sinus formation was higher in the polypropylene suture material (9%) compared to the polydioxanone suture material (2%) in the delayed postoperative period. The incidence of palpable knots was higher in the polypropylene suture material (23%) compared to the polydioxanone suture material. No cases of incisional hernia were reported with polydioxanone suture material.

Conclusions The overall morbidity from abdominal closure was considerably reduced in the Polydioxanone group. We encountered reduction in wound complications like burst abdomen, wound infection, wound pain, suture sinus formation, palpable knots and incisional hernia. Therefore, polydioxanone can be employed rewardingly in emergency situations where closure can be carried out safely and rapidly.