Continuous Absorbable vs Interrupted Nonabsorbable Fascial Closure

Abstract

• A prospective, randomized comparison of continuous, absorbable, No. 2, coated, polyglycolic acid suture (DexonPlus) vs interrupted, nonabsorbable, No. 28 monofilament stainless steel wire suture was performed in 105 patients for midline fascial closure following gastric surgery for morbid obesity. The preoperative weight, sex distribution, and type of operation were not significantly different between the two groups. No significant difference was found in the wound complication rate between the two closure methods (7/54 for wire and 8/51 for polyglycolic acid). There were one dehiscence and five incisional hernias in the wire group and five hernias in the polyglycolic acid group. Continuous closure was accomplished in significantly less time (21±8 minutes) than interrupted closure (43±19 minutes). An additional 121 patients underwent continuous No. 2 polyglycolic acid fascial closure after the end of the randomized trial, with 13 wound complications, including ten incisional hernias. In conclusion, continuous, absorbable suture closure for laparotomy wounds is recommended for its economy of time and the lack of significant difference from an interrupted, nonabsorbable wound closure. (Arch Surg 1986;121:821-823)