Page 104 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Chapter 5
Table 3 List of the most commonly used suture materials to close abdominal wall incisions and their characteristics
Suture
Prolene Surgipro Ethilon Monosof Ethibond Mersilene Surgilon Maxon PDS
PDS plus
Monoplus Monomax
Vicryl Vicryl plus
Polysorb Dexon
Producer
Ethicon Covidien Ethicon Covidien Ethicon Ethicon Covidien Covidien Ethicon Ethicon
B Braun B Braun
Ethicon Ethicon
Covidien Covidien
Material Absorbable
Polypropylene Non
Polypropylene Non
Nylon Non
Nylon Non
Polyethylene Non
Polyester Non
Nylon Non
Polyglyconate Slowly
Polydioxanone Slowly
Polydioxanone + Slowly triclosan
Polydioxanone Slowly
Poly-4- Slowly hydroxybutyrate
Polyglactin Rapidly
Polyglactin + Rapidly triclosan
Polyglycolic acid Rapidly
Polygglycolic Rapidly acid
Absorption time
180 days 183–238 days 183–238 days
180–201 days 390–1080 days
56–70 days 56–70 days
60–90 days 60–90 days
Filaments Antibiotics impragnated
Mono No Mono No Mono No Mono No Multi No Multi No Multi No Mono No Mono No Mono Yes
Mono No Mono No
Multi No Multi Yes
Multi No Multi No
Non-absorbable versus slowly absorbable sutures
No di erence in incisional hernia rate for continuous suturing of midline incisions with slowly absorbable versus non-absorbable sutures (p= 0.75) was identi ed(48). However, an increased incidence of prolonged wound pain (p< 0.005) and suture sinus formation (p= 0.02) with non-absorbable sutures was reported(48). Another MA (which included non-midline incisions) identi ed no di erence in incisional hernia rate between slowly-absorbable polydioxanone and non-absorbable sutures (OR 1.10: p= 0.43)(43). Once again, non-absorbable sutures had a signi cant higher risk of suture sinus formation (OR 0.49: p= 0.01) (43).
Statement
Using slowly-absorbable suture material instead of non-absorbable sutures for continuous closure of midline abdominal wall incisions in elective surgery is suggested.
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