Running Mass Closure of Abdominal Wounds Using Absorbable Looped Suture

Abstract

Three hundred patients undergoing celiotomies had fascial incisions closed using O-Maxon looped suture employing a knot-free running modification of the Smead Jones method. Two hundred ninety-three patients were evaluated prospectively to determine efficacy and safety of this technique. Seventy-two percent of patients underwent celiotomies for treatment of malignant diseases. A vertical incision was used in 79% and a transverse incision in 21% of patients. Mean fascial closure time was 8.4 minutes (range 3-32), without a significant difference between the vertical and transverse incisions. Overall suture handling was judged as excellent in 44% of the patients and good in 54%. Six weeks postoperatively, wounds were healed in 99% of patients, with less than 1% having residual infection or unclosed, granulating wounds. No herniation or fascial dehiscences occurred in this series. We conclude that Maxon looped suture employing a knot-free running Smead Jones technique appears to be a safe, efficient, and effective closure method in this group of patients. Further follow-up will be required to show whether this outcome is sustained.

An In Vitro Comparison of Two Suture Intervals Using Braided Absorbable Loop Suture in the Equine Linea Alba

“…Despite theoretical advantages and efficacy of use in humans, [24][25][26][27] rats, 28 and dogs 29 the strength and safety of looped suture for use in horses will require further evaluation. In comparison with a previous study assessing effects of closure pattern on bursting strength in the equine linea alba, 10 the looped suture performed equivalently to a closure technique using single stranded #3 polyglactin 910 suture in a simple continuous pattern with a suture bite and interval of 1.5 cm  1.5 cm, respectively (reported mean AE SD bursting pressure of 433.5 AE 39.4 mm Hg); however, the failure mode was appreciably different between studies.…”

“…14,23 Using suture on a loop would minimize the number of knots, thereby reducing the possibility of knot failure, and the mass of foreign material in the wound, while promoting faster closure. Loop suture has been used to close celiotomy incisions in humans, [24][25][26][27][28][29] and has been reported to be safe and efficient to close celiotomy incisions in rats 28 and dogs. 29 We are unaware of reports describing use of loop sutures for closure of ventral median celiotomy incisions in horses.…”