Creep Behavior of Commonly Used Suture Materials in Abdominal Wall Surgery

Nout, Erik; Lange, Johan F.; Salu, Nathalie E.; Wijsmuller, Arthur R.; Hop, Wim C.J.; Goossens, Richard H.M.; Snijders, Chris J.; Jeekel, Johannes; Kleinrensink, Gerrit-Jan

doi:10.1016/j.jss.2006.06.001

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Volume 138, Issue 1 , Pages 51-55, March 2007

Creep Behavior of Commonly Used Suture Materials in Abdominal Wall Surgery

Erik Nout, M.D.
- Department of Neurosciences – Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Lowlands Institute of Surgical and applied Anatomy (LISA)—Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
Johan F. Lange, M.D., Ph.D.
- Lowlands Institute of Surgical and applied Anatomy (LISA)—Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Surgery—MCRZ, Rotterdam, The Netherlands
- Department of General Surgery—Erasmus MC University Medical Center, Rotterdam, The Netherlands
Nathalie E. Salu, M.Sc.
- Department of Neurosciences – Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Lowlands Institute of Surgical and applied Anatomy (LISA)—Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
Arthur R. Wijsmuller, M.Sc.
- Department of General Surgery—Erasmus MC University Medical Center, Rotterdam, The Netherlands
Wim C.J. Hop, Ph.D.
- Department of Epidemiology and Biostatistics—Erasmus MC University Medical Center, Rotterdam, The Netherlands
Richard H.M. Goossens, Ph.D.
- Faculty of Industrial Design Engineering—Delft University of Technology, Delft, The Netherlands
Chris J. Snijders, Ph.D.
- Department of Biomedical Physics and Technology—Faculty of Medicine, Erasmus MC, Rotterdam, The Netherlands
Johannes Jeekel, M.D., Ph.D.
- Department of General Surgery—Erasmus MC University Medical Center, Rotterdam, The Netherlands
Gerrit-Jan Kleinrensink, Ph.D.
- Department of Neurosciences – Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Lowlands Institute of Surgical and applied Anatomy (LISA)—Faculty of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- To whom correspondence and reprint requests should be addressed at Department of Neuroscience/Lowlands Institute of Surgical and Applied Anatomy, Erasmus MC University Medical Center, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.

Received 8 September 2005 published online 29 November 2006.

Background

The incidence of incisional hernia after abdominal wall closure is high. Furthermore, recurrence is a significant complication after correction of all abdominal wall hernias. Besides surgeon- and patient-related factors, in this experimental study a third factor, i.e., creep behavior of suture materials, is introduced and evaluated.

Materials and methods

Creep measurements were performed on 0 and 2-0 Prolene (Ethicon, Johnson & Johnson Intl., Somerville, NJ) and 1 and 2-0 PDSII (Ethicon, Johnson & Johnson Intl.) sutures. Two different loads were used representing normal intra-abdominal pressure (IAP) and pathological IAP. A mean percentage of elongation was calculated for each type of suture material. Statistical analysis was performed using analysis of variance.

Results

All suture materials showed significant (3–51%) creep behavior. Prolene sutures showed more creep than PDSII sutures in both loading conditions.

Conclusions

As significant creep was demonstrated for commonly used suture materials, creep might be a significant influential factor with regard to the etiology of incisional hernias and recurrence after abdominal wall hernia repair.

Key Words: suture, creep, incisional hernia, abdominal wall hernia, intra-abdominal pressure