Fishing Line Suture: Cost‐saving Alternative for Atraumatic Intracutaneous Skin Closure—Randomized Clinical Trial in Rwanda

Abstract

Experience with the use of nylon fishing line for surgical sutures has been reported from several African countries. A recent publication suggested that fishing line and an injection needle may provide an atraumatic suture that is especially suitable for intracutaneous skin closures. This article provides further empirical support for such alternative technology. We describe a randomized, blinded clinical trial conducted in Butare (Rwanda) with 220 cutaneous wounds closed by intracutaneous sutures, with either the homemade suture or a commercial nylon thread (Ethilon). We compared the clinical outcomes as well as the costs of those two materials. There are no significant differences between the two sutures in terms of clinical findings or in the reported ease of use by the surgeons. The cost of a homemade atraumatic suture is US $0.07, which is less than one-thirtieth the cost of the commercial thread. The advantage of the commercial thread is the assurance of quality. We consider whether this quality assurance justifies the large price difference, and if the homemade suture should be recommended to surgeons in countries where the costs of surgical material often remain an obstacle for life-saving operations.

Commercial Mesh versus Nylon Mosquito Net for Hernia Repair. A Randomized Double‐blind Study in Burkina Faso

“…In poor countries where commercial thread is not available, surgeons use sterilized Nylon fishing line bought at the local market. [3][4][5][6] Nevertheless, despite extensive clinical experience with Nylon sutures, there are few publications about the use of Nylon meshes in hernia repair. Nylon implants have mostly been used for closure of laparostomies or darn.…”

Study of Operative Outcomes of Hernioplasty Using Mosquito Net Mesh at a Tertiary Hospital

“…It is used for several types of sutures. A sterilised polyethylene fishing line from the local market is used by surgeons in some low-middle income countries (LMIC) where the commercial surgical thread is not readily available [ 6 , 7 ].…”

“…Freudenberg S et al [7] They concluded from their study that homemade sutures should be recommended to surgeons in countries where the cost of surgical materials often remains an obstacle to life-saving operations.…”

Sterilized Mosquito Net versus Commercial Mesh for Hernia Repair

“…In the early days of mesh implantation nylon meshes were used, but later replaced by stronger materials with less chronic inflammation. Nylon fishing line has recently been recommended for skin closure [19,20] .…”