Background: The incidence of incisional hernia after abdominal wall closure is high. Furthermore, recurrence is a significant complication after correction of all abdominal wall hernias. Besides surgeon- and patient-related factors, in this experimental study a third factor, i.e., creep behavior of suture materials, is introduced and evaluated. Materials and methods: Creep measurements were performed on 0 and 2-0 Prolene (Ethicon, Johnson & Johnson Intl., Somerville, NJ) and 1 and 2-0 PDSII (Ethicon, Johnson & Johnson Intl.) sutures. Two different loads were used representing normal intra-abdominal pressure (IAP) and pathological IAP. A mean percentage of elongation was calculated for each type of suture material. Statistical analysis was performed using analysis of variance. Results: All suture materials showed significant (3-51%) creep behavior. Prolene sutures showed more creep than PDSII sutures in both loading conditions. Conclusions: As significant creep was demonstrated for commonly used suture materials, creep might be a significant influential factor with regard to the etiology of incisional hernias and recurrence after abdominal wall hernia repair.

abdominal wall hernia, creep, incisional hernia, intra-abdominal pressure, suture,
Journal of Surgical Research
Department of Oral and Maxillofacial Surgery

Nout, E, Lange, J.F, Salu, N.E, Wijsmuller, A.R, Hop, W.C.J, Goossens, R.H.M, … Kleinrensink, G.J. (2007). Creep Behavior of Commonly Used Suture Materials in Abdominal Wall Surgery. Journal of Surgical Research, 138(1), 51–55. doi:10.1016/j.jss.2006.06.001