Comparison of incisional bursting strength of simple continuous and inverted cruciate suture patterns in the equine linea alba

Objective-To determine the bursting strength of ventral median abdominal in cisions closed by either simple continuous or inverted cruciate suture patt erns. Study Design-Experimental. Animal or Sample Population-Twelve equine cadavers. Methods-A 25 cm ventral median incision was made through the lines alba and a 200 L polyurethane bladder was placed within the abdomen. Either a simpl e continuous or an inverted cruciate pattern using 3 polyglactin 910 with a bite size and suture interval of 1.5 cm was used to close linea incisions. Closure time was recorded for each pattern. The bladder was inflated with air at 40 L/min, and the pressure at body wall Failure recorded. The length of suture used for wound closure and the wound failure modes were recorded . Deviation from the linea (cm), total suture length (nm); suture length to wound length ratio (SL:WL), closure time (min), bursting pressure (mm Hg), and failure modes were compared between groups using Welch-Aspin t-tests. The effects of independent subject variables were assessed for possible eff ects on bursting strength using analysis of covariance. Results-Mean bursting pressure was significantly greater For the simple con tinuous pattern than for the inverted cruciate pattern (P = .01). Significa ntly less suture material (P = .0002) was required with the continuous patt ern than with the inverted cruciate pattern. Mean closure time, SL:WL, devi ation from the lines, and failure modes were not significantly different be tween groups. No significant effects were noted for independent variables i n both groups on bursting strength. Conclusions-In this model, a simple continuous closure pattern for ventral median abdominal incisions was stronger than an inverted cruciate pattern. A simple continuous pattern leaves less foreign material in the wound, whic h may be of benefit in reducing incisional complications. Clinical Relevance-Use of a continuous closure pattern for the linea alba m ay offer greater wound security during episodes of increased intra-abdomina l pressure in horses. (C) Copyright 1999 by The American College of Veterin ary Surgeons.