RESULTS OF A CONTROLLED TRIAL COMPARING 3 SLOWY ABSORBABLE SUTURE MATERIALS FOR THE CLOSURE OF SUPRA-UMBILICAL MIDLINE LAPAROTOMIES

A randomized prospective trial was carried out between September 1987 and February 1989 to compare 3 different absorbable sutures (polyglact ine 910, polydioxanone I, polydioxanone II) for closure of the abdomin al wall after upper midline laparotomy for elective operations. The te chnique used to close the fascia was always a continuous suture. The c riteria used to assess the results were the development of wound infec tion and wound dehiscence in the early postoperative period, and the d evelopment of suture sinuses and incisional hernia 1 year after operat ion. The early postoperative results in 235 patients revealed no wound infection and no -wound dehiscence. Suture sinuses developed in 4 pat ients (2 %) 2 months after operation, but resolved spontaneously. We r eviewed 203 patients after one year. The total number of incisional he rnias detected 1 year postoperatively was 22 cases (11 %), (polyglacti ne 910, 14.2 %; polydioxanone I, 11.2 %; polydioxanone II, 8,4 %). The difference between the 3 groups was not statistically significant. Th e results of the trial indicate that absorbable sutures have a very lo w incidence of suture sinuses, and that polydioxanone II seems to be a good choice for closing laparotomies.