A Randomized Prospective Study of 571 Patients Comparing Continuous vs. Interrupted Suture Techniques

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Abstract
A randomized, prospective study was designed to compare a continuous with an interrupted technique for closing an abdominal incision. A total of 571 patients were randomized between the closure methods and stratified as to type of wound: clean, clean-contaminated or contaminated. In midline incisions, the dehiscence rate was 2.0% (5/244) for the continuous group vs. 0.9% (2/229) for the interrupted group. The difference was not statistically significant. Ventral hernias formed in 2.0% (4/201) of the continuous group vs. 0.5% (1/184) of the interrupted group. The type of wound had no influence on the results. In oblique incisions, 0% (0/39) of wounds closed continuously dehised while 2% (1/50) of incisions closed interruptedly dehised. No ventral hernias formed. Dehiscence was more likely related to improper surgical technique than to the method of closure. An abdominal incision could be closed with a continuous suture in approximately half the time required for placing interrupted sutures (20 vs. 40 min). A continuous closure is preferred because it is more expedient and because it has the same incidence of wound disruption compared with an interrupted closure.