Evaluation of peritoneal closure at laparotomy

Abstract

Laparotomy closure was performed in rats with and without peritoneal suture. Both paramedian and midline incisions were used. The incidence of adhesions to the parietal peritoneum was significantly higher when the peritoneum was sutured, more so with catgut. The peritoneal surface reperitonealized in 7 days when peritoneum was not sutured. The tensile and bursting strength was studied on the 7th and 14th day, and was found to be similar in both midline and paramedian incisions whether or not the peritoneum had been sutured. The same results were obtained whether continuous or interrupted sutures of the muscle sheath with monofilament nylon was used. We believe that the peritoneum should not be sutured at laparotomy closure and that a midline incision with rectus sheath closure using monofilament nylon should be used as it is less time-consuming and provides sufficient strength to the abdomen.