DesCôteaux J G, Temple W J, Huchcroft S A, Frank C B, Shrive N G
Department of Surgery, University of Calgary, Alberta, Canada.
J Invest Surg. 1993 Mar-Apr;6(2):201-9. doi: 10.3109/08941939309141609.
An experiment was conducted to determine the optimal distance between sutures in closure of abdominal midline incisions. Human cadaveric fascia was harvested soon after death and stored at -70 degrees C until testing. Suture pullout tests were performed to determine the maximal force applied to the fascia before pullout. Fascia from the opposite side of the same cadaver was used as a control. In a first series of testing, we observed that the pullout force of two sutures dropped linearly as they were brought closer than 12 mm apart. In a second series we observed no increase in pullout force using multiple sutures closer together compared to fewer sutures 15 mm apart. The experiments suggest that the mechanical requirements of closing a midline abdominal incision are met by placing sutures 10-15 mm apart.
