Small stitches with small suture distances increase laparotomy closure strength.

Background: There is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia.
Methods: Thirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm).
Results: The geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006).
Conclusions: Small stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions.