A Randomised Control Trial Comparing the Efficacy Of Polydiaxanone II And Polypropylene Suture Material For Midline Vertical Abdominal Incision Using Interrupted X Sutures In Prevention Of Burst Abdomen

Abstract

Background: ABSTRACT Abdominal wound dehiscence is a common complication of emergency laparotomy. Its prevention in important to reduce postoperative morbidity and mortality. The search for the optimal laparotomy technique has gone on for more than 100 years and will continue. Research Hypothesis: The application of Polydiaxanone ( PDS II ) suture material in reducing the risk of burst abdomen in midline laparotomy wound. Objectives: To compare the incidence and risk of burst abdomen, wound infection and sinus formation with Polydiaxanone ( PDS II ) versus Polypropylene ( PPL ) in midline laparotomy wounds. Design: Open randomized trial with two arms. Setting: Surgical wards of K.L.E.Society’s Dr Prabakar Kore Hospital & M.R.C., Belgaum. Material and Methods: 60 patients undergoing laparotomy through a midline vertical incision were randomized after informed consent, to either a Polydiaxanone ( PDS II ) versus Polypropylene ( PPL ) suture material. Outcome variable:- The incidence and risk of burst abdomen, wound infection and suture sinus formation. Predictor variable:- Intraperitoneal sepsis, abdominal distension, cough, diabetes, malignancy and anemia. IX Statistical analysis:- The incidence and relative risk ( RR ) of burst abdomen, wound infection and sinus formation using Polypropylene ( PPL ) group as the reference category were calculated. Results: There was 1 burst abdomen ( out of 30 cases, 3.3% ) in Polypropylene ( PPL ) group and none ( out of 30 ) in Polydiaxanone ( PDS II ) . The RR of burst could not be calculated because of 0 in one arm. The incidence of wound infection was 16.6% in Polypropylene ( PPL ) ( 5 out of 30 cases) compared to 10% ( 3 out of 30 cases) in Polydiaxanone ( PDS II ) . The relative risk ( RR ) of wound infection was 0.60 . The incidence of suture sinus was 10% ( 3 out of 30 cases) in Polypropylene ( PPL ) as compared to 3.3% in Polydiaxanone ( PDSII ) group. Conclusion: The risk of burst abdomen, wound infection& suture sinues is less with the use of Polydiaxanone ( PDS II ) .