Optimal sutures for use in the abdomen: an evaluation based on the formation of adhesions and abscesses.
OBJECTIVE
This study explored the optimal suture materials for use in the peritoneal cavity based on the formation of adhesions and abscesses under clean and contaminated conditions.


METHODS
The parietal peritoneum and muscle layer of rats were incised. The incision was followed by interrupted suturing in the clean group. A suspension of E. coli (1.0 × 10(6)) plus Bacteroides fragilis (1.0 × 10(5)) was sprayed onto the incision in the contaminated group, followed by interrupted suturing. Four types of sutures were used: nonabsorbable multifilament silk, absorbable multifilament Polyglactin 910 (Vicryl(®)), absorbable monofilament Polydioxanone (PDS(®)), and Poliglecaprone 25 (Monocryl(®)). The rats were killed at 2, 4 or 8 weeks after the surgery.


RESULTS
The incidence of adhesions in the clean group was low with Polyglactin 910. The incidence of adhesions was 96 % or higher regardless of the suture type in the contaminated group. The incidence of severe adhesions was low with Polyglactin 910 and Poliglecaprone 25 and significantly higher with Polydioxanone in the contaminated group. The incidence of abscess formation around the silk was significantly higher than the other three types of sutures in the contaminated group.


CONCLUSIONS
Polyglactin 910 was less likely to form adhesions than the other three types of sutures under both conditions, suggesting that Polyglactin 910 may be the optimal type of suture to use in the peritoneal cavity.
Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Kenji
K
Ishikawa
Sotaro
S
Sadahiro
Yoichi
Y
Tanaka
Toshiyuki
T
Suzuki
Akemi
A
Kamijo
Seiki
S
Tazume
D018784:Abdominal Abscess / Q000209:etiology / Q000517:prevention & control*; D000818:Animals; D001442:Bacteroides Infections / Q000209:etiology / Q000517:prevention & control; D001441:Bacteroides fragilis; D004146:Dioxanes; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000209:etiology / Q000517:prevention & control; D008297:Male; D010537:Peritoneum / Q000601:surgery*; D016687:Polydioxanone; D011091:Polyesters; D011098:Polyglactin 910; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D016037:Single-Blind Method; D013537:Sutures; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*
D004146:Dioxanes; D011091:Polyesters; D016687:Polydioxanone; D011098:Polyglactin 910; C095495:glycolide E-caprolactone copolymer