Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model
Purpose: After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional hernia. The objective of this study was to measure the suture tension in small and large bites with a new suture material.
Methods: Closure of the linea alba was performed with small bites (i.e., 5 mm between two consecutive stitches and 5 mm distance from the incision) and large bites (i.e., 10 mm × 10 mm) with Duramesh™ size 0 (2 mm) and PDS II 2-0 in 24 experiments on six porcine abdominal walls. The abdominal wall was fixated on an artificial computer-controlled insufflatable abdomen, known as the ‘AbdoMan’. A custom-made suture tension sensor was placed in the middle of the incision.
Results: The suture tension was significantly lower with the small bites technique and Duramesh™ when compared with large bites (small bites 0.12 N (IQR 0.07–0.19) vs. large bites 0.57 N (IQR 0.23–0.92), p < 0.025). This significant difference was also found in favour of the small bites with PDS II 2-0 (p < 0.038). No macroscopic tissue failure was seen during or after the experiments.
Conclusion: Closure of the abdominal wall with the small bites technique and Duramesh™ was more efficient in dividing suture tension across the incision when compared to large bites. However, suture tension compared to a conventional suture material was not significantly different, contradicting an advantage of the new suture material in the prevention of burst abdomen and incisional hernia during the acute, postoperative phase.
|Biomedical sensor, Incisional hernia, Laparotomy closure, Suture tension|
|Hernia: the journal of hernias and abdominal wall surgery|
|Organisation||Department of Surgery|
Yurtkap, Y, den Hartog, F.P.J, van Weteringen, W, Jeekel, J, Kleinrensink, G.J, & Lange, J.F. (2020). Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model. Hernia: the journal of hernias and abdominal wall surgery. doi:10.1007/s10029-020-02140-7