A comparative study on four methods of tension suture of abdominal incision

Objective: To explore the ideal tension suture for abdominal incision.Methods:Summarized the 161 cases with tension suture on abdominal rectus incision or median incision.Four types of tension suture were categorized: A.The traditional full-thickness intermittent tension suture method;B.The full-thickness intermittent horizontal mattress(U-shaped) tension suture method;C.Buried tension suture with Coated VICRYL Plus Antibacterial suture + Conventional layered suture with virgin silk;D.Buried tension suture with Coated VICRYL Plus Antibacterial suture + layered fascia suture with Coated VICRYL Plus Antibacterial suture.The healing rate of class A and the rate of incision disruption were assessed.Results:The healing rate of class A of group D was higher than group A and group C(P0.05).There was no statistical difference between group D and group B,however there was 1 case reporting quite serious necrosis of skin and soft tissue.The healing rate of class A of group B was higher than group A(P0.05).The healing rate of class A of group C+D was higher than group A+B(P0.05).There was no significant difference regarding the rate of incision disruption between each group.Conclusion:The full-thickness intermittent horizontal mattress(U-shaped) tension suture method involved less incidences of incision complications,compared to the traditional full-thickness intermittent tension suture method,however effort should be paid to maintain appropriate suture intervals and tension,to avoid local tissue necrosis.Buried tension suture with Coated VICRYL Plus Antibacterial suture involved minimum incision complications,and saved the post-surgical procedures of removing stitches.The thorough application of abdominal suture(except skin) with Coated VICRYL Plus Antibacterial suture further was worth promotion,which can reduce the incidences of thread-end reaction,and the chronic formation of sinus.