Influence of suture material and suture technique on collagen fibril diameters in midline laparotomies

Background: Although laparotomy closure is associated with a cumulative 15% failure rate, the effect of different suture techniques and materials on t he ultrastructural composition of the healing incision has not been investi gated. Method: in 40 Wistar rats the collagen fibril diameters and the regenerativ e tissue were compared using electron microscopy 14 and 28 days after midli ne laparotomy. Wounds were closed with single and running sutures using eit her polypropylene or polyglactin 910. Results: Closure with polypropylene led to significantly larger mean fibril diameters than closure with polyglactin. Regardless of time and suture mat erial, running closure resulted in significantly smaller mean collagen fibr il diameters than single sutures. Four weeks after laparotomy, inflammatory reactions, disorganization of collagen and irregularities of the vascular architecture were found after closure with absorbable suture material but n ot after closure with nonabsorbable material. Conclusion: Suture material and suture method significantly influence the u ltrastructural composition of the healing incision. Persisting mechanical i rritation around the suture threads after single sutures and severe persist ing inflammatory reactions after the use of absorbable suture material are important influencing factors. Copyright (C) 2001 S.Karger AG, Basel.