Principles of Abdominal Wound Closure

An experimental study in rats was designed to measure the effect of tissue bite size and tightness of tying on the wound's ability to resist dehiscence from increased intra-abdominal pressure. Abdominal incisions in rats were closed in one of four ways: large tissue bites, tied tightly or loosely, or small tissue bites, tied tightly or loosely. The strongest closure was with large tissue bites and loose ties. The weakest closure was with small bites and tight ties. It appeared that tying sutures loosely was a little more important than taking large bites, although the difference was not significant. Each of these factors was a contributing element.