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Prabha Shankar A, Mathew S, Tippana VSSN, B R K, Naik S, Pandita RK, L B, Kumar An N, Narasimha Rao V V, Kumar Bhat B, Moharana AK, Ts D. A Prospective Randomized Controlled Trial Comparing Clinical Equivalence of PD Synth and PDS Polydioxanone Sutures. Cureus 2023; 15:e50293. [PMID: 38205458 PMCID: PMC10776896 DOI: 10.7759/cureus.50293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction Incisional hernia is a common complication of midline laparotomy that may develop even after several years of surgery. Abdominal fascia closure with ideal suture material reduces the incidence of incisional hernia. This study compared the clinical equivalence of PD Synth (Healthium Medtech Limited) and PDS (Ethicon, Johnson & Johnson) slowly absorbed polydioxanone suture with respect to the occurrence of incisional hernia, following elective/emergency midline laparotomy. Methods Eighty-eight subjects undergoing elective/emergency midline laparotomy were randomized to PD Synth (n=45) and PDS (n=43) groups of this prospective, multicenter, randomized (1:1), single-blind, two-arm, parallel-group study (December 2020-May 2023). Primary endpoint was incidence of incisional hernia, occurring within six and 12 months of surgery. Secondary endpoints included incidence of fascial dehiscence, surgical site infection (SSI), suture sinus, seroma, hematoma, scar tenderness, and re-suturing, and evaluation of operative data, hospital stay, intra-operative suture handling, pain, time to return to normal day-to-day activities and work, overall patient satisfaction score, and adverse events. Results One subject in both PD Synth and PDS groups (p>0.05) developed incisional hernia at umbilicus 12 months post-laparotomy. In PDS group, one subject each had incidences of SSI on day 2, day 7, and one month, two subjects developed seroma on day seven, and one subject had readmission on one month; two subjects in PD Synth group developed superficial SSI (one month). Findings of other secondary endpoints were comparable between the groups. Conclusion Primary and secondary outcomes manifested that PD Synth and PDS slowly absorbed polydioxanone sutures are clinically equivalent, and can be used for abdominal fascial closure following midline laparotomy.
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Affiliation(s)
- Amritha Prabha Shankar
- Department of Surgical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Stanley Mathew
- Department of General Surgery, Kasturba Medical College and Kasturba Hospital, Manipal, IND
| | - V S S Nagababu Tippana
- Department of General Surgery, King George Hospital/Andhra Medical College, Visakhapatnam, IND
| | - Keerthi B R
- Department of Surgical Oncology, Vydehi Institute of Medical Sciences & Research Centre, Bengaluru, IND
| | - Saleem Naik
- Department of General Surgery, Batra Hospital and Medical Research Center, New Delhi, IND
| | - Ravinder K Pandita
- Department of General Surgery, Batra Hospital and Medical Research Center, New Delhi, IND
| | - Badareesh L
- Department of General Surgery, Kasturba Medical College and Kasturba Hospital, Manipal, IND
| | - Naveen Kumar An
- Department of Surgical Oncology, Kasturba Medical College, Manipal, IND
| | - Venkata Narasimha Rao V
- Department of Surgical Oncology, Kasturba Medical College and Kasturba Hospital, Manipal, IND
| | - Bharath Kumar Bhat
- Department of Gastrosurgery, Kasturba Medical College and Kasturba Hospital, Manipal, IND
| | - Ashok K Moharana
- Department of Clinical Affairs, Healthium Medtech Limited, Bengaluru, IND
| | - Deepak Ts
- Department of Clinical Affairs, Healthium Medtech Limited, Bengaluru, IND
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