Negative side-effects of retention sutures for abdominal wound closure. A prospective randomised study

Abstract

Objective: To assess the effect of retention sutures on the postoperative course of patients after major abdominal operations. Design: Prospective, randomised study. Setting: Teaching hospital, Germany. Subjects: 95 patients who were at increased risk of wound failure after major abdominal operations. Intervention: Conventional mass closure either with (n = 44) or without (n = 51) reinforcement by wire retention sutures. Main outcome measures: Pain intensity on postoperative days 3, 6, 9, and 12, patients' acceptance, retention-suture-related morbidity, general morbidity. Results: Postoperative pain was overall more severe with retention sutures. On day 6, 31/49 control patients but only 13/41 patients with retention sutures were pain-free (p = 0.003, 95% CI 0.12 to 0.51). Twelve of 44 patients with retention sutures developed local complications of the sutures, and 21 of the 44 had to have them removed prematurely, in most cases because of intolerable pain. Conclusions: Retention sutures used to close abdominal wounds cause inconvenience, pain, and specific morbidity.