Comparison of Prolene Versus Polydioxanone (PDS) for Midline Laparotomy Wound Closure: A Randomized Controlled Trial
M. Talha Saeed1*, Syed Hasham Ahmad1, Ahsan Nayyer1
1Rawalpindi Medical University / Allied Hospitals, Pakistan.
*Corresponding Author: M. Talha Saeed, Rawalpindi Medical University / Allied Hospitals, Pakistan.
DOI: https://doi.org/10.58624/SVOAMR.2026.04.022
Received: August 07, 2026
Published: September 30, 2026
Citation: Saeed MT, Ahmad SH, Nayyer A. Comparison of Prolene Versus Polydioxanone (PDS) for Midline Laparotomy Wound Closure: A Randomized Controlled Trial. SVOA Medical Research 2026, 4:5, 190-194. doi: 10.58624/SVOAMR.2026.04.022
Abstract
Background: Closure of the abdominal wall after laparotomy is critical to minimize postoperative complications such as wound infections, burst abdomen, and incisional hernias. The choice of suture material is pivotal since an ideal suture should provide adequate strength, be tension free, minimize ischemia, and reduce the risk of infection. Traditionally, nonabsorbable sutures like Prolene have been used; however, their propensity to provoke foreign body reactions may predispose patients to higher infection rates. In contrast, absorbable materials such as Polydioxanone (PDS) offer prolonged tensile strength with gradual absorption, potentially reducing infection risks.
Objective: This study aimed to compare Prolene and PDS in terms of wound infection rates following midline abdominal wound closure in patients undergoing laparotomy.
Study Design and Setting: A randomized controlled trial was conducted at RMU and Allied Hospitals over a six-month period (April 2021 to September 2021).
Methods: A total of 140 patients meeting the inclusion criteria (ages 14–70 years, undergoing midline laparotomy for either elective or emergency indications) were enrolled. Patients with previous midline incisions, gynecological surgeries, diabetes, carcinoma, or immunocompromised status were excluded. Participants were randomized by lottery into two equal groups (n = 70 each). Group A underwent abdominal wall closure using nonabsorbable Prolene, while Group B received absorbable PDS. Closure was performed using a continuous single-layer mass closure technique incorporating both anterior and posterior rectus sheaths. Postoperatively, patients were managed with daily dressings and followed weekly for one month to evaluate for surgical site infection (SSI). Wound infections were defined as clinical evidence of deep tissue separation, erythema, or purulent/serous discharge confirmed by culture where applicable.
Results: Demographic characteristics were comparable between groups. The mean age in Group A was 38.16 ± 16.37 years and 39.69 ± 17.73 years in Group B, with similar gender distributions. Analysis revealed a statistically significant difference in wound infection rates: 54.3% (38/70) in the Prolene group versus 24.3% (17/70) in the PDS group (p = 0.000). Stratified analyses by age, gender, body mass index, duration of surgery, and whether the case was emergency versus elective further supported the lower infection rate with PDS.
Conclusion: The study demonstrated that closure with absorbable PDS results in a significantly lower rate of wound infection compared to nonabsorbable Prolene in midline laparotomy closures. These findings suggest that PDS may be the preferred suture material for reducing postoperative wound complications in this setting. Further multicenter trials are recommended to validate these results and explore long-term outcomes.