Creep behavior of commonly used suture materials in abdominal wall surgery.
BACKGROUND
The incidence of incisional hernia after abdominal wall closure is high. Furthermore, recurrence is a significant complication after correction of all abdominal wall hernias. Besides surgeon- and patient-related factors, in this experimental study a third factor, i.e., creep behavior of suture materials, is introduced and evaluated.


METHODS
Creep measurements were performed on 0 and 2-0 Prolene (Ethicon, Johnson & Johnson Intl., Somerville, NJ) and 1 and 2-0 PDSII (Ethicon, Johnson & Johnson Intl.) sutures. Two different loads were used representing normal intra-abdominal pressure (IAP) and pathological IAP. A mean percentage of elongation was calculated for each type of suture material. Statistical analysis was performed using analysis of variance.


RESULTS
All suture materials showed significant (3-51%) creep behavior. Prolene sutures showed more creep than PDSII sutures in both loading conditions.


CONCLUSIONS
As significant creep was demonstrated for commonly used suture materials, creep might be a significant influential factor with regard to the etiology of incisional hernias and recurrence after abdominal wall hernia repair.
Nout
Erik
E
Department of Neurosciences, Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Lange
Johan F
JF
Salu
Nathalie E
NE
Wijsmuller
Arthur R
AR
Hop
Wim C J
WC
Goossens
Richard H M
RH
Snijders
Chris J
CJ
Jeekel
Johannes
J
Kleinrensink
Gerrit-Jan
GJ
D034861:Abdominal Wall / Q000601:surgery*; D046449:Hernia, Abdominal / Q000209:etiology*; D006801:Humans; D066298:In Vitro Techniques; D008422:Materials Testing / Q000295:instrumentation / Q000379:methods*; D016687:Polydioxanone; D011126:Polypropylenes; D011183:Postoperative Complications / Q000209:etiology*; D011312:Pressure; D013537:Sutures / Q000009:adverse effects*; D014159:Transducers
D011126:Polypropylenes; D016687:Polydioxanone