Comparison of non-absorbable (polypropylene) versus delayed absorbable (polydioxanone) suture material for abdominal wound closure after laparotomy

Abstract

Background: Type of suture material used for fascial closure in laparotomies influences the incidence of post-operative complications. Currently there is no consensus on the superiority of either absorbable or non-absorbable suture materials for abdominal fascial closure. Aim of this study was to determine the superior suture material for abdominal wall closure after elective laparotomy among polypropylene and polydioxanone based on the occurrence of specific post-operative complications.Methods: A prospective observational study was conducted at Kasturba hospital, Manipal from September 2014 to August 2016. Patients admitted under General surgery, who underwent midline laparotomy were included in the study. Polydioxanone and Polypropylene suture materials were used for mass closure and post-operative complications were compared.Results: Hundred patients were included. The two study groups (Prolene and Polydioxanone) were homogenous, with no significant difference between age, BMI, co-morbidities and indication for surgery. Surgical site infection was significantly more in prolene group (p=0.031). Duration of surgeries was longer in prolene group (p=0.020), hence, a subgroup analysis was done and only surgeries under 4-hour duration were analysed. It showed no difference between the two groups with respect to surgical site infection (p=0.320). There was no significant difference between the two groups in burst abdomen and incisional hernia.Conclusions: There was no significant difference between Prolene and Polydioxanone when early and late post-operative complications were compared. Hence, either of the two suture materials can be used for abdominal wound closure in elective midline laparotomies.