title: An ideal suture for midline abdominal closure?
abstract: BACKGROUND
  Within the last decade the customary trend of using non absorbable sutures has changed, with numerous studies and meta-analyses advocating the use of slowly absorbable sutures, claiming comparable wound strength with significantly lower incidence of wound complications. It was the objective of this randomized clinical trial to compare two universally accepted suture materials, the non-absorbable Nylon and the slowly absorbable Polydioxanone for midline abdominal closure in the Indian context.
  
  
  METHODS
  64 patients undergoing midline laparotomy were allocated, using block randomization, to mass closure of the abdominal wall with continuous polyamide (34 patients) or continuous polydioxanone (30 patients).
  
  
  RESULTS
  There was an alarmingly higher incidence of wound dehiscence in the PDS group requiring secondary suturing (Nylon 0; PDS 5). Mid-way through the trial, an interim analysis was performed which revealed an unacceptably high incidence of wound dehiscence in the PDS group. This necessitated a premature curtailment of the study. There was, however, a statistically significantly higher incidence of scar pain in the Nylon group (Nylon 9; PDS 1).
  
  
  CONCLUSIONS
  There is a need for a study with larger series, and PDS as a choice of suture for midline wound closure cannot be recommended.
authors.affiliation: Department of Surgery, Christian Medical College and Hospital, Ludhiana, 141 008 Punjab India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Gaikwad
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kapoor
authors.forename: Robin
authors.initials: R
authors.lastname: Thambudorai
keywords: Midline abdominal closure; Polyamide; polydioxanone