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Small Tissue Bites and Wound Strength
An Experimental Study
Yucel Cengiz, MD;
Peter Blomquist, MD,PhD;
Leif A. Israelsson, MD,PhD
Arch Surg. 2001;136:272-275.
Hypothesis Placing stitches close to the cut wound edge does not produce low wound bursting strength in midline laparotomy incisions closed with a suture length:wound length ratio of 4.
Design Experimental study in rats.
Methods Midline incisions were closed with a running suture in 51 Sprague-Dawley rats. A suture length:wound length ratio of 4 was used and stitches were placed at a distance of 3, 6, or 10 mm from the wound edge. Wound bursting strength was studied immediately after and 4 days after wound closure.
Results Immediately after wound closure, bursting pressure was higher with stitches placed 10 mm from the wound edge than those at a distance of 3 mm. After 4 days, bursting pressure and bursting volume were lower with stitches placed 10 mm from the wound edge than those at a distance of 3 or 6 mm. The abdominal wall ruptured outside the suture line in 14 of 17 wounds closed with 21 stitches, in 11 of 17 wounds closed with 16 stitches, and in 6 of 17 wounds closed with 11 stitches (P= .02).
Conclusions Four days after closure of midline laparotomy incisions using a suture length–wound length ratio of 4, wound bursting strength is higher with stitches placed 3 to 6 mm from the wound edge than those at a distance of 10 mm. Wound bursting strength increases with the number of stitches used.
From the Departments of Surgery, Sundsvall County Hospital, Sundsvall (Drs Cengiz and Israelsson), and the University of Lund, University Hospital MAS, Malmö (Dr Blomquist), Sweden.
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Effect of Stitch Length on Wound Complications After Closure of Midline Incisions: A Randomized Controlled Trial
Millbourn et al.
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ABSTRACT
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