Wound strength after midline laparotomy: a comparison of four closure techniques in rats

The primary objective of this study was to determine which closure technique simple interrupted suture (SIS), simple continuous suture (SCS), interrupted double loop closure (IDLC) or continuous double loop closure (CDLC) results in stronger wound repair after midline laparotomy. Surgery was performed on 48 male rats. On the 5th postoperative day the rats were sacrificed and wound strength was measured by inserting a balloon into the abdomen and filling it with air until the abdomen burst. Pressure was measured in millimetres of mercury. Abdominal bursting pressure was 281.25 ± 26.5 mm Hg (mean ± SD) in the SIS group, 287.91 ± 29.6 mm Hg in the SCS group, 295.41 ± 31.9 mm Hg in the IDLC group and 314.58 ± 24.7 mm Hg in the CDLC group (P<0.05). Closure of the midline abdominal incisions using SCS has almost the same wound strength as SIS or IDLC but it is recommended because of simplicity, speed, and costs. CDLC ensures the greatest wound strength on the basis of the intraperitoneal pressure required to burst the abdomen. The results of the comparison of the SIS to SCS, as well as IDLC to CDLC, show that continuous suture techniques are more favourable than the interrupted suture techniques from which they were derived.