OC-056 CLOSURE STRENGTH OF SUTURE TECHNIQUES AND SUTURE MATERIALS

Abstract

Abstract Aim Small bites closure is being implemented as standard of care (SOC) for laparotomy closure, but no consensus on which suture material to use is reached. The aim of our study was to compare biomechanical properties of four different closure techniques to SOC. Materials & Methods Fifty porcine abdominal walls were divided into five groups: 1. SOC (2/0 polydioxanone); 2. interlocking 2/0 polydioxanone; 3. size 0 barbed polydioxanone; 4. size 0 barbed glycolic acid and trimethylenecarbonate (GATC); 5. size 0 suturable polypropylene mesh. The small bites technique was used for closure of the linea alba in all groups. The abdominal walls were divided into a supra- and infra-umbilical half, which resulted in 20 specimens per group that were pulled apart in a tensile testing machine. Maximum tensile strength and types of suture failure were registered. Results The highest tensile strength was measured in the barbed polydioxanone arm (334.8 N ± 157.0) but did not reach statistical significance compared to the other groups. Infra-umbilical abdominal walls endured a significantly higher maximum tensile force compared to supra-umbilical (397 N vs 271 N, p<0.001). Resorbable GATC barbed suture failed significantly more often (25% vs 0%, p = 0.008). Conclusion When using small bites for fascial closure, the highest tensile strength was found using size 0 barbed polydioxanone suture, but results were similar among all groups. Tensile strength in infra-umbilical abdominal walls was significantly higher compared to supra-umbilical. Use of GATC barbed suture should be discouraged, as this suture fails significantly more often.