A Study of 300 Consecutive Cases of Abdominal Wound Closure with Alloy Stainless Wire Sutures

For the past eight years, following closely on the advent of early ambulation of surgical patients, the use of alloy steel wire sutures in the closure of abdominal wounds has been the incentive for many reports and much clinical discussion. The pioneer work in the use of metallic suture was reported by Babcock,' Jones,6 Kaufman,6 and others. This article is a clinical summary of 300 consecutive cases of routine closure with alloy steel wire offering evidence which we feel indicates its superiority over other forms of suture material in application to presentday needs and policies for the protection of the patient from so-called unavoidable complications. Twenty-five years ago the senior author began his surgical training under men who were disciples of Halsted. For years he advocated silk until the disadvantages of the material became apparent and made him reconsider its usage. These have been summarized by DeCoursy8 as follows: (i) Silk is nonabsorbable, therefore only interrupted sutures can be used. (ii) When infection is present, a persistent sinus may be formed. The silk may be extruded any time up to two years after operation. If the silk is not extruded, tedious dissection may be necessary. (iii) With large stay sutures especially, the movement of tissue fluids is promoted by the capillarity of the strand and bacteria may thus be carried throughout the whole wound. (iv) Deeply buried silk may cause a rare tumor (Schloffer's). (v) Ends of silk sutures irritating bowel may cause ulceration.