Small stitches with small suture distances increase laparotomy closure strength

BackgroundThere is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia.MethodsThirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm).ResultsThe geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006).ConclusionsSmall stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions.