An in vitro comparison of two suture intervals using braided absorbable loop suture in the equine linea alba.

OBJECTIVE To compare bursting strength and failure modes of ventral median abdominal incisions closed with loop suture in a simple continuous pattern using two different suture-bite intervals. STUDY DESIGN In vitro experiment. SAMPLE POPULATION Equine cadavers (n=14; weighing >318 kg; postmortem interval <2 hours). METHODS A template was used to make a 25 cm incision with suture interval and bite size of either 1.0 cm x 1.5 cm or 1.5 cm x 1.5 cm. A 200 L polyurethane bladder was inserted within the abdomen and insufflated to create abdominal wall tension. Celiotomies were closed with a #2 braided lactomer 9-1 continuous pattern with a loop suture. Deviation from the linea, closure time (minutes), total suture length (cm), suture length to wound ratio (SL:WL), bursting pressure (mm Hg), and failure modes (fascial or suture) were compared between groups using a Mann-Whitney U test. Significance was set at P<.05. RESULTS No significant differences were identified between closing time, total suture length used, SL:WL, bursting pressure, or failure mode. Fascial failure was the main failure mode for both techniques; suture failure occurred rarely and knot failure did not occur. CONCLUSION Based on the overall bursting pressure and failure mode, #2 braided lactomer loop suture placed in a continuous pattern should provide sufficient security for closure of the equine linea alba during recovery and the immediate postoperative period. CLINICAL RELEVANCE Although there were no significant differences in the 2 patterns evaluated, the 1.5 cm x 1.5 cm pattern may have potential advantages for closure time, less total suture remaining in the wound, and strength.

[1]  T. Pavlidis,et al.  Complete dehiscence of the abdominal wound and incriminating factors. , 2001, The European journal of surgery = Acta chirurgica.

[2]  G. Nasir,et al.  Continuous double loop closure for midline laparotomy wounds. , 2001, Saudi medical journal.

[3]  S. Wang,et al.  Incisional Hernia after Laparotomy: Prospective Randomized Comparison between Early-absorbable and Late-absorbable Suture Materials , 2000, World Journal of Surgery.

[4]  R. Malthaner,et al.  The search for an ideal method of abdominal fascial closure: a meta-analysis. , 2000, Annals of surgery.

[5]  L. Galuppo,et al.  Comparison of incisional bursting strength of simple continuous and inverted cruciate suture patterns in the equine linea alba. , 1999, Veterinary surgery : VS.

[6]  A. Kummeling,et al.  Closure of the rectus sheath with a continuous looped suture and the skin with staples in dogs: speed, safety, and costs compared to closure of the rectus sheath with interrupted sutures and the skin with a continuous subdermal suture. , 1998, The Veterinary quarterly.

[7]  M. Carlson,et al.  Acute wound failure. , 1997, The Surgical clinics of North America.

[8]  J. Trimbos,et al.  Continuous double loop closure: A new technique for repair of laparotomy wounds , 1997, The British journal of surgery.

[9]  R. Vanderby,et al.  An evaluation of six synthetic casting materials: strength of cylinders in bending. , 1995, Veterinary surgery : VS.

[10]  M. Markel,et al.  A study of the biomechanical properties of the adult equine linea alba: relationship of tissue bite size and suture material to breaking strength. , 1994, Veterinary surgery : VS.

[11]  P. Disaia,et al.  Experience with a mass closure technique using continuous looped polyglyconate absorbable suture. , 1994, Journal of the American College of Surgeons.

[12]  J. Bailey,et al.  Mechanical properties of suture materials in vitro and after in vivo implantation in horses. , 1992, Veterinary surgery : VS.

[13]  P. Disaia,et al.  Running mass closure of abdominal wounds using absorbable looped suture. , 1990, Journal of gynecologic surgery.

[14]  Campbell Ja,et al.  A biomechanical study of suture pullout in linea alba. , 1989 .

[15]  P. Pascoe,et al.  Factors affecting incisional complication rates associated with colic surgery in horses: 78 cases (1983-1985). , 1989, Journal of the American Veterinary Medical Association.

[16]  R. Brand,et al.  Tissue Reaction and Surgical Knots: The Effect of Suture Size, Knot Configuration, and Knot Volume , 1989, Obstetrics and gynecology.

[17]  G. Robinson,et al.  Knot security of suture materials. , 1989, Veterinary surgery : VS.

[18]  E. Santschi,et al.  Continuous absorbable suture pattern in the closure of ventral midline abdominal incisions in horses. , 1988, Equine veterinary journal.

[19]  L. Freeman,et al.  Tissue reaction to suture material in the feline linea alba. A retrospective, prospective, and histologic study. , 1987, Veterinary surgery : VS.

[20]  G. V. Poole Mechanical factors in abdominal wound closure: the prevention of fascial dehiscence. , 1985, Surgery.

[21]  J. Meredith,et al.  Suture technique and wound-bursting strength. , 1984, The American surgeon.

[22]  R. Sanders,et al.  Principles of abdominal wound closure. I. Animal studies. , 1977, Archives of surgery.

[23]  T. P. Jenkins The burst abdominal wound: A mechanical approach , 1976, The British journal of surgery.