Suture length to wound length ratio in 175 small animal abdominal midline closures

Tensile testing in feline ventral abdominal coeliotomy closure with different sizes of polydioxanone suture material: a biomechanical study

OBJECTIVES

The aim of this study was to evaluate, in vitro, the load and type of failure of the sutured ventral abdominal fascia of cats with different sizes of suture material made of polydioxanone (PDX) (2-0, 3-0, 4-0, 5-0 USP).

METHODS

A total of 32 samples of the ventral abdominal wall from 16 cadaveric cats were harvested using an hourglass-shaped template. The samples were sectioned longitudinally along the linea alba and then sutured together in a continuous pattern using four different randomly assigned sizes of pdx suture material (2-0, 3-0, 4-0, 5-0 USP). A universal testing machine was used for linear distraction of the samples. The tensile strength and type of failure were recorded and analysed. Three types of failure were defined: suture material failure (S), suture line failure (T1) and failure of the abdominal wall further away from the linea alba (T2).

RESULTS

The frequency of suture material failure decreased with increasing suture size. Suture size 5-0 failed due to a S failure in 6/8 samples, PDX 4-0 failed in 2/8 samples and PDX 3-0 failed in only 1/8 samples. However, PDX 2-0 failed due to only T1 or T2 failures, with both failures being almost equally represented. No statistically significant differences in the load to failure between PDX 2-0, 3-0 and 4-0 were noted (P >0.05). The risk of suture failure increased with decreasing suture size diameter.

CONCLUSIONS AND RELEVANCE

PDX 2-0 and 3-0 can be used without reservation for the closure of ventral midline coeliotomy in cats. Although there was no statistically significant difference between PDX 2-0, 3-0 and 4-0, PDX 4-0 showed a higher probability for suture breakage and should be used only after careful consideration of the patient while clinical evaluation is pending. Pdx 5-0 cannot be recommended as a safe suture size for this type of surgical closure.

Advances and Techniques in Subcuticular Suturing for Abdominal Wall Closure: A Comprehensive Review

Subcuticular suturing has emerged as a prominent technique for abdominal wall closure, offering notable benefits in cosmetic outcomes, infection reduction, and patient satisfaction. This comprehensive review delves into the evolution and current state of subcuticular suturing, examining its principles, techniques, and advancements. Traditional methods like continuous and interrupted suturing are compared with modern innovations like barbed sutures and knotless techniques. Clinical outcomes, including healing efficacy, complication rates, and cost-effectiveness, are analyzed to highlight the technique's advantages. The review also explores specific applications in various surgical specialities, presenting case studies and clinical trials to substantiate its effectiveness. Despite certain challenges and limitations, the future of subcuticular suturing appears promising with ongoing research and technological advancements. This review aims to thoroughly understand subcuticular suturing, emphasizing its significance in improving surgical outcomes and patient care in abdominal wall closure.