Early laparotomy wound dehiscence: a randomized comparison of three suture materials and two methods of fascial closure.

Early fascial disruption occurs in 1 to 3 per cent of abdominal operations. It is a serious complication with 15 to 20 per cent mortality. In this study 195 laparotomy patients were randomized into three categories without regard to the preoperative diagnosis. The fascia was sutured either with polyglycolic acid, polyglyconate or polypropylene suture. The polyglycolic acid suture was used in an interrupted fashion, whereas the polyglyconate and the polypropylene sutures were inserted continuously. The incidence of acute fascial disruption was 1.4 per cent in the polyglycolic acid group, 4.8 per cent with polyglyconate and 11.3 per cent with polypropylene. According to this study, there is no significant difference between using a continuous running polyglyconate suture or an interrupted polyglycolic acid suture. Polypropylene was less ideal.