A systematic review on the effectiveness of slowly-absorbable versus non-absorbable sutures for abdominal fascial closure following laparotomy
Open Access
- 31 December 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in International Journal of Surgery
- Vol. 9 (8), 615-625
- https://doi.org/10.1016/j.ijsu.2011.09.006
Abstract
ObjectiveTo systematically analyse the effectiveness of delayed-absorbable (Polydioxanone; PDS) versus non-absorbable (Polypropylene; Prolene, and Nylon) for abdominal fascial closure in patients undergoing laparotomy.MethodsRandomised trials evaluating PDS versus Prolene/Nylon for abdominal fascial closure were selected and analysed by using the statistical tool RevMan® where summative data was expressed as odds ratio (OR).ResultsEight randomised trials encompassing 4261 patients undergoing laparotomy closure with either PDS or Prolene/Nylon were retrieved. There was no statistically significant heterogeneity among trials. In the fixed effect model PDS was comparable to Prolene/Nylon in terms of risk of incisional hernia (OR, 1.10; 95% CI, 0.87, 1.37; z = 0.79; p = 0.43), wound dehiscence (OR, 1.04; 95% CI, 0.67, 1.62; z = 0.19; p = 0.85), peri-operative complications (OR, 0.94; 95% CI, 0.66, 1.33; z = 0.37; p = 0.71), suture sinus formation (OR, 0.58; 95% CI, 0.33, 1.04; z = 1.84; p = 0.07) and surgical site infection (OR, 0.98; 95% CI, 0.68, 1.39; z = 0.14; p = 0.89). Subgroup analysis separately comparing Prolene and Nylon with PDS supported same outcome.ConclusionPDS and Prolene/Nylon are equally effective for the closure of abdominal fascia following laparotomy. Given that there are no significant differences between two suture materials, further studies may be conducted to evaluate their cost-effectiveness and measurement of health-related quality of life instead of analysing their effectiveness in laparotomy closureKeywords
This publication has 30 references indexed in Scilit:
- Open suture versus mesh repair of primary incisional hernias: a cost–utility analysisHernia, 2009
- The Biology of Hernia FormationSurgical Clinics of North America, 2008
- The biology of hernias and the abdominal wallHernia, 2006
- Laparoscopic versus open ventral hernia mesh repair: a prospective studySurgical Endoscopy, 2006
- Incisional HerniasDigestive Surgery, 2003
- Meta-analysis of techniques for closure of midline abdominal incisionsBritish Journal of Surgery, 2002
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002
- Incisional hernia: the problem and the cureJournal of the American College of Surgeons, 1999
- Closure of midline laparotomy incisions with polydioxanone and nylon: The importance of suture techniqueBritish Journal of Surgery, 1994
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986