Abdominal Wound Closure: Choice of Suture

Experiments were designed to test suture materials for their use in potentially infected abdominal wound closure. The nearest to the ideal, at present available, is a monofilament nonabsorbable suture, the one tested being monofilament nylon. The suture retained adequate strength in the infected and noninfected state over a 70-day period. This is particularly important as infection has been shown to result in low wound strength in the early phases of healing. The monofilamentous nature of this suture represented an advantage when sutures were examined electronmicroscopically. Infected, braided sutures viewed for the first time by electronmicroscopy were shown to contain bacteria and polymorphonuclear cells, even after 70 days implantation. The normal absorption and encapsulation of these sutures was delayed by the presence of infection. Polyglycolic acid had marked strength when new but rapidly weakened after implantation. This together with slowed absorption in the infected state is a disturbing feature in terms of wound failure and sinus formation respectively.