Small stitches with small suture distances increase laparotomy closure strength.
BACKGROUND
There is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia.


METHODS
Thirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm).


RESULTS
The geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006).


CONCLUSIONS
Small stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions.
Harlaar
Joris J
JJ
Department of General Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. j.harlaar@erasmusmc.nl
van Ramshorst
Gabrielle H
GH
Nieuwenhuizen
Jeroen
J
Ten Brinke
Joost G
JG
Hop
Wim C J
WC
Kleinrensink
Gert-Jan
GJ
Jeekel
Hans
H
Lange
Johan F
JF
D034861:Abdominal Wall / Q000601:surgery*; D000818:Animals; D006547:Hernia / Q000517:prevention & control*; D016687:Polydioxanone; D011183:Postoperative Complications / Q000517:prevention & control; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013536:Suture Techniques; D013552:Swine; D013718:Tensile Strength
D016687:Polydioxanone