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Abstract
The aim of our experimental biomechanical study was to compare the strength of two different midline laparotomy suture techniques: simple suture and reinforced tension line (RTL) suture.
Materials and methods : Sixty midline laparotomies on cadavers were performed: simple and RTL sutures in each 30 cases. Cadavers were patients who died in the hospital during the last 24 hours and had no previous abdominal operations and no arterial aneurysm disease. Simple and RTL sutures were made with slowly absorbable polydioxanone (PDS II loop, 1/0 size). The strength of both sutures was measured with tensiometer and expressed in Newton (N). The maximal suture strength was assessed at the moment when the suture tore the tissues.
Results : The simple suture strength was significantly lower than RTL suture strength (86.3 ± 16.8 N vs. 113 ± 16.6 N, p < 0.001). The midline laparotomy suture strength increased up to 31% when RTL suture was performed. The RTL suture strength was significantly higher in all three abdomen regions: epigastric (80 ± 15.7 N vs. 106.6 ± 14 N, p < 0.001), umbilical (86.2 ± 16 N vs. 112.9 ± 14.8 N, p < 0.001) and hypogastric (93.7 ± 17.2 N vs. 120.7 ± 18.1 N, p < 0.001).
Conclusions : The reinforced tension line suture is significantly stronger than simple suture when closing the midline laparotomy. This suture can be used in patients with higher fascia dehiscence or incisional hernia risk.
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L. Venclauskas
L. Venclauskas, Ph.D. Clinic of Surgery Kaunas University of Medicine Eiveniu 2 Kaunas 50009, Lithuania Tel.: +370/37324412 Fax: +370/37326152 E-mail: [email protected]