title: Creep behavior of commonly used suture materials in abdominal wall surgery.
abstract: 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.
authors.affiliation: Department of Neurosciences, Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Nout
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
authors.forename: Nathalie E
authors.initials: NE
authors.lastname: Salu
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Wijsmuller
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Richard H M
authors.initials: RH
authors.lastname: Goossens
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Snijders
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeekel
authors.forename: Gerrit-Jan
authors.initials: GJ
authors.lastname: Kleinrensink
mesh_terms: 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
chemical_list: D011126:Polypropylenes; D016687:Polydioxanone