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. 2009 Sep;198(3):392-5.
doi: 10.1016/j.amjsurg.2008.10.018. Epub 2009 Mar 12.

Small stitches with small suture distances increase laparotomy closure strength

Joris J Harlaar  1 , Gabrielle H van Ramshorst, Jeroen Nieuwenhuizen, Joost G Ten Brinke, Wim C J Hop, Gert-Jan Kleinrensink, Hans Jeekel, Johan F Lange
Affiliations

Small stitches with small suture distances increase laparotomy closure strength

Joris J Harlaar et al. Am J Surg. 2009 Sep.

Abstract

Background: There is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia.

Methods: Thirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm).

Results: The geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006).

Conclusions: Small stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions.

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