A Randomized Controlled Trial Comparing the Efficacy of the Delayed Absorbable Polydiaxanone (PDS) Versus Non-Absorbable Polypropylene Sutures for Abdominal Wall Closure Following Midline Laparotomies

Hamna  Asif; Muhammad Hanif  Abbassi; Muhammad Ali Zar  Qureshi; Muhammad  Hamza Afzal

doi:10.54112/bcsrj.v6i5.1948

Authors

Hamna Asif Department of General Surgery, Combined Military Hospital Jhelum, Pakistan
Muhammad Hanif Abbassi Department of General Surgery, Combined Military Hospital Jhelum, Pakistan
Muhammad Ali Zar Qureshi Department of Pharmacy, Riphah International University, Lahore, Pakistan
Muhammad Hamza Afzal Bioinformatician ITMO University, Saint Petersburg, Russia

DOI:

https://doi.org/10.54112/bcsrj.v6i5.1948

Keywords:

Polydiaxanone, Polypropylene, Suture, Abdominal Wall Closure, Laparotomy, Wound Healing, Wound Dehiscence, Southampton Score, Surgical Site Infection, Visual Analog Scale

Abstract

Abdominal wall closure following midline laparotomy remains a critical factor influencing postoperative morbidity. The choice of suture material plays a crucial role in preventing wound-related complications, such as surgical site infections, dehiscence, and impaired wound healing. Objective: To compare the clinical outcomes of delayed absorbable polydiaxanone (PDS) versus non-absorbable polypropylene sutures for abdominal wall closure in midline laparotomies. Methods: A randomized controlled trial was conducted at Combined Military Hospital, Jhelum, from July 2023 to December 2023. A total of 60 patients undergoing midline laparotomy were randomly assigned to two groups: PDS (n = 30) and polypropylene (n = 30). The primary outcome was wound dehiscence at 30 days post-surgery. Secondary outcomes included surgical site infection (assessed using the Southampton scoring system), postoperative pain (assessed at 7-day and 14-day follow-up), time to wound healing, and duration of hospital stay. Statistical analysis was performed using the chi-square test and the independent t-test, with p < 0.05 considered significant. Results: Wound dehiscence occurred less frequently in the PDS group compared to polypropylene (3.0% vs. 10.0%; p = 0.045). Surgical site infection was significantly lower in the PDS group (p = 0.03), with improved wound healing noted. Postoperative pain scores at 7 and 14 days were significantly reduced in the PDS group (p = 0.02). No significant difference was observed in the length of hospital stay between the two groups. Conclusion: Delayed absorbable polydiaxanone (PDS) sutures demonstrated superior outcomes over non-absorbable polypropylene sutures in terms of reduced wound dehiscence, fewer surgical site infections, faster wound healing, and lower postoperative pain, without affecting hospital stay. These findings suggest PDS as a preferable choice for midline abdominal wall closure.

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