Effect of stitch length on wound complications after closure of midline incisions: a randomized controlled trial

Archives of Surgery
Daniel MillbournL A Israelsson

Abstract

In midline incisions closed with a single-layer running suture, the rate of wound complications is lower when a suture length to wound length ratio of at least 4 is accomplished with a short stitch length rather than with a long one. Prospective randomized controlled trial. Surgical department. Patients operated on through a midline incision. Wound closure with a short stitch length (ie, placing stitches <10 mm from the wound edge) or a long stitch length. Wound dehiscence, surgical site infection, and incisional hernia. In all, 737 patients were randomized: 381 were allocated to a long stitch length and 356, to a short stitch length. Wound dehiscence occurred in 1 patient whose wound was closed with a long stitch length. Surgical site infection occurred in 35 of 343 patients (10.2%) in the long stitch group and in 17 of 326 (5.2%) in the short stitch group (P = .02). Incisional hernia was present in 49 of 272 patients (18.0%) in the long stitch group and in 14 of 250 (5.6%) in the short stitch group (P < .001). In multivariate analysis, a long stitch length was an independent risk factor for both surgical site infection and incisional hernia. In midline incisions closed with a running suture and having a suture length to wound...Continue Reading

Citations

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Nov 13, 2012·Langenbeck's Archives of Surgery·Leif A Israelsson, Daniel Millbourn
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