Comparing clinical outcomes between patients receiving non-absorbable and delayed absorbable sutures for abdominal wound closure after laparotomy

Background: There is a lot of debate about the best suture for repairing the abdominal fascia post-laparotomy. This research compared the clinical results of patients who received non-absorbable versus delayed absorbable sutures for abdominal wound closure after laparotomy. Methods: We conducted a prospective non-randomized clinical trial in the Department of General Surgery, Janaki Medical College and Teaching Hospital, Janakpur, Nepal. We included patients aged more than 18 years who underwent an elective laparotomy surgery with midline vertical incision for any indication between April 2020 till March 2022 in our department. Two study groups were formed: non-absorbable suture (polypropylene suture) and delayed absorbable suture (polydiaxanone suture). Results: The two study groups were similar with respect to indication of surgery (p value = 0.52). Bowel was opened in 81% in non-absorbable group and in 85% in delayed absorbable suture group. Mean duration of surgery was found to be significantly lower in the delayed absorbable suture group as compared to non-absorbable suture group (185±21.8 vs. 232±27.3 minutes, p value < 0.05). Post-operative complications included surgical site infection, burst abdomen, incisional hernia and sinus formation. It was observed that surgical site infection rate was significantly higher among non-absorbable suture group patients as compared to delayed absorbable suture group (25% vs. 13%, p value <0.05). Conclusions: Comparing early and late post-operative complications, there was no statistically significant difference between non-absorbable suture group and delayed absorbable suture group.