Skin Closure at Laparoscopy

Abstract

The choice of wound closure material after laparoscopy is often based more on the preference or familiarity of the surgeon than on scientific facts. This study attempted to discern the best method for wound closure after laparoscopy. Ninety women were randomized to receive interrupted 3-0 nylon sutures, subcuticular 3-0 polyglactin sutures, or Steri-Strips. At the umbilical port site, the rectus sheath was closed with one 0 polyglactin suture and then one of the three materials for skin closure. The lateral ports received a combination of two of the materials, allowing each patient to act as her own control. Each site was covered with a standard adhesive dressing that was removed before discharge. Women recorded pain at each site from days 1 to 5 on a linear analog scale, described wound appearance, and reported their ultimate satisfaction. The operating surgeons also assessed the wound outcome at the 4-week follow-up visit, although they did not know the material used for wound closure.