Monofilament versus multifilament absorbable sutures for abdominal closure

Abstract

This study compares monofilament continuous absorbable sutures with multifilament interrupted absorbable sutures for abdominal closure. Before closure of an abdominal incision, 988 patients were randomized to receive either a monofilament polyglyconate (Maxon) or a multifilament polyglactin 910 (Vicryl) suture. At 1 year after operation, 684 patients (69 per cent) were examined for the presence of incisional hernia, sinus and other wound-healing problems; 179 (18 per cent) had died and 125 (13 per cent) did not attend for follow-up. Incisional hernia occurred in 8 per cent of patients receiving monofilament continuous sutures compared with 6 per cent of those having multifilament interrupted closure (P not significant). Wound dehiscence occurred in 1 per cent of both groups. The mean time for suturing was 7.1 min for monofilament continuous and 8.7 min for multifilament interrupted sutures (P < 0.001). It is concluded that closure of an abdominal incision can be effected by a monofilament continuous absorbable suture more quickly than by multifilament interrupted absorbable sutures without an increased risk of wound dehiscence or incisional hernia.

Closure of the rectus sheath with a continuous looped suture and the skin with staples in dogs: Speed, safety, and costs compared to closure of the rectus sheath with interrupted sutures and the skin with a continuous subdermal suture

“…The 17% reduction in abdominal closure time in our study achieved by closing the rectus sheath with a continuous suture is similar to the 18% found by Sahlin et al (30), but less than the 50 to 60% reported by others (18,20,25). These greater reductions in closure time may have been due to the larger incisions in some studies (18,20).…”

“…The rate of abdominal wound dehiscence has been reported to range from 0 to 3.1% (8,15,22,25,30,31,39). Continuous closure is at least as safe as interrupted closure if correctly performed (1, 5,17,18,20,22,25,27,30,33).…”

“…Continuous closure is at least as safe as interrupted closure if correctly performed (1, 5,17,18,20,22,25,27,30,33). This implies that an adequate portion of rectus sheath is included in each suture bite, that the sutures are not tied too tightly, and that the suture material is not grasped by instruments that may damage it (6,22,32).…”

“…The costs per dog in group 1 were nearly two times as high as in group 2 ( (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) were used. The unused staples were discarded.…”

“…The advantages of a continuous suture are speed, an equal distribution of tension, less foreign material in the wound, and less wound trauma (5,17,25,27,33). The safety of continuous sutures has been shown to be equal to that of interrupted closure (5,18,20,27,30). Recently a looped suture has been introduced for continuous closure of the rectus sheath.…”