Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure.
BACKGROUND
Incisional hernia is a frequent complication of abdominal surgery, often requiring surgical intervention. This prospective randomized trial compared suture materials for closure of the fascia after abdominal surgery.


METHODS
In 456 patients the abdominal fascia was closed with either non-absorbable (polypropylene; Prolene(®)) or absorbable (polydioxanone; PDS(®)) suture material. Follow-up was by clinical examination and ultrasonography at 6-month intervals. Outcome measures were incisional hernia, surgical-site infection and suture sinus.


RESULTS
Some 223 patients were analysed after closure with Prolene(®) and 233 after PDS(®) . Median follow-up was 32 and 31 months respectively. There was no significant difference in the incidence of incisional hernia between the groups: 20·2 per cent (45 of 223) for Prolene(®) and 24·9 per cent (58 of 233) with PDS(®) (P = 0·229). Kaplan-Meier analysis showed a cumulative rate after 4 years of 23·7 and 30·2 per cent for Prolene(®) and PDS(®) respectively (P = 0·222). Secondary outcome measures showed no significant differences.


CONCLUSIONS
The incidence of incisional hernia in both groups was higher than expected from previous literature. There were no significant differences between the two suture methods.


BACKGROUND
ISRCTN65599814 (http://www.clinical-trials.com).
Department of General Surgery, Orbis Medical Centre, PO Box 5500, 6130 MB Sittard, The Netherlands.
A
A
Bloemen
P
P
van Dooren
B F
BF
Huizinga
A G M
AG
Hoofwijk
D034861:Abdominal Wall / Q000601:surgery*; D005260:Female; D006555:Hernia, Ventral / Q000517:prevention & control*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016687:Polydioxanone / Q000627:therapeutic use*; D011126:Polypropylenes / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013537:Sutures; D016896:Treatment Outcome; D014945:Wound Healing
D011126:Polypropylenes; D016687:Polydioxanone