Negative side-effects of retention sutures for abdominal wound closure. A prospective randomised study

Objective: To assess the effect of retention sutures on the postoperative c ourse of patients after major abdominal operations. Design: Prospective, randomised study. Setting: Teaching hospital, Germany. Subjects: 95 patients who were at increased risk of wound failure after maj or abdominal operations. Intervention: Conventional mass closure either with (n =44) or without (n = 51) reinforcement by wire retention sutures. Main outcome measures: Pain intensity on postoperative days 3, 6, 9, and 12 , patients' acceptance, retention-suture-related morbidity, general morbidi ty. Results: Postoperative pain was overall more severe with retention sutures. On day 6, 31/49 control patients but only 13/41 patients with retention su tures were pain-free (p = 0.003, 95% CI 0.12 to 0.51). Twelve of 44 patient s with retention sutures developed local complications of the sutures, and 21 of the 44 had to have them removed prematurely, in most cases because of intolerable pain. Conclusions: Retention sutures used to close abdominal wounds cause inconve nience, pain, and specific morbidity.