Influence of suture material and suture technique on collagen fibril diameters in midline laparotomies.
BACKGROUND
Although laparotomy closure is associated with a cumulative 15% failure rate, the effect of different suture techniques and materials on the ultrastructural composition of the healing incision has not been investigated.


METHODS
in 40 Wistar rats the collagen fibril diameters and the regenerative tissue were compared using electron microscopy 14 and 28 days after midline laparotomy. Wounds were closed with single and running sutures using either polypropylene or polyglactin 910.


RESULTS
Closure with polypropylene led to significantly larger mean fibril diameters than closure with polyglactin. Regardless of time and suture material, running closure resulted in significantly smaller mean collagen fibril diameters than single sutures. Four weeks after laparotomy, inflammatory reactions, disorganization of collagen and irregularities of the vascular architecture were found after closure with absorbable suture material but not after closure with nonabsorbable material.


CONCLUSIONS
Suture material and suture method significantly influence the ultrastructural composition of the healing incision. Persisting mechanical irritation around the suture threads after single sutures and severe persisting inflammatory reactions after the use of absorbable suture material are important influencing factors.
Höer
J
J
Department of Surgery, University Hospital RWTH Aachen, Germany. johoer99@yahoo.de
Anurov
M
M
Titkova
S
S
Klinge
U
U
Töns
C
C
Ottinger
A
A
Schumpelick
V
V
D000818:Animals; D003094:Collagen / Q000648:ultrastructure*; D007813:Laparotomy; D008297:Male; D008854:Microscopy, Electron; D011098:Polyglactin 910; D011126:Polypropylenes; D051381:Rats; D017208:Rats, Wistar; D013536:Suture Techniques; D013537:Sutures; D014945:Wound Healing
D011126:Polypropylenes; D011098:Polyglactin 910; D003094:Collagen