Continuous abdominal fascial closure: a randomized controlled trial of poly(L-lactide/glycolide)

Objective. The objective was to compare the handling characteristics and : 6 month clinical outcome using a No. I long-term absorbable multifilament suture poly(L-lactide/glycolide) (PLG) or the permanent monofilament (No. 1) polypropolene using a continuous fascial closure. Methods. During the 13-month study interval, 203 high-risk patients were enrolled in this randomized prospective trial. All were managed under a strict perioperative management protocol. Results. There was no clinically significant difference in patient demographics. Seventy percent carried a diagnosis of abdominal malignancy. The mean body mass index of the population was 33.1. Wound variables including incision length, incision site, measured subcutaneous tissue thickness, and method of subcutaneous dissection did not differ. During the evaluation of suture handling properties PLG was judged to be statistically superior (P < 0.001) in lack of springback, knot tie-down smoothness, knot security, knot strength, and surgical hand. The monofilament suture was judged superior (P < 0001) in ease of tissue passage. There was no difference in incisional pain, suture rejection, superficial wound dehiscence, infection, seroma, or hernia. Conclusion. PLG suture represents a suitable nonpermanent suture alternative for fascial closure in patients at risk for poor wound outcome. (C) 2003 Elsevier Science (USA). All rights reserved.