title: A systematic review on the effectiveness of slowly-absorbable versus non-absorbable sutures for abdominal fascial closure following laparotomy.
abstract: OBJECTIVE
  To systematically analyse the effectiveness of delayed-absorbable (Polydioxanone; PDS) versus non-absorbable (Polypropylene; Prolene, and Nylon) for abdominal fascial closure in patients undergoing laparotomy.
  
  
  METHODS
  Randomised trials evaluating PDS versus Prolene/Nylon for abdominal fascial closure were selected and analysed by using the statistical tool RevMan where summative data was expressed as odds ratio (OR).
  
  
  RESULTS
  Eight randomised trials encompassing 4261 patients undergoing laparotomy closure with either PDS or Prolene/Nylon were retrieved. There was no statistically significant heterogeneity among trials. In the fixed effect model PDS was comparable to Prolene/Nylon in terms of risk of incisional hernia (OR, 1.10; 95% CI, 0.87, 1.37; z = 0.79; p = 0.43), wound dehiscence (OR, 1.04; 95% CI, 0.67, 1.62; z = 0.19; p = 0.85), peri-operative complications (OR, 0.94; 95% CI, 0.66, 1.33; z = 0.37; p = 0.71), suture sinus formation (OR, 0.58; 95% CI, 0.33, 1.04; z = 1.84; p = 0.07) and surgical site infection (OR, 0.98; 95% CI, 0.68, 1.39; z = 0.14; p = 0.89). Subgroup analysis separately comparing Prolene and Nylon with PDS supported same outcome.
  
  
  CONCLUSIONS
  PDS and Prolene/Nylon are equally effective for the closure of abdominal fascia following laparotomy. Given that there are no significant differences between two suture materials, further studies may be conducted to evaluate their cost-effectiveness and measurement of health-related quality of life instead of analysing their effectiveness in laparotomy closure.
authors: Department of General & Colorectal Surgery, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK. surgeon1wrh@hotmail.com
authors: M S
authors: MS
authors: Sajid
authors: U
authors: U
authors: Parampalli
authors: M K
authors: MK
authors: Baig
authors: M R
authors: MR
authors: McFall
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D020341:Absorbable Implants; D046449:Hernia, Abdominal / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007813:Laparotomy; D009757:Nylons; D016687:Polydioxanone; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D013537:Sutures
chemical_list: D009757:Nylons; D011126:Polypropylenes; D016687:Polydioxanone