What type of suture is most commonly used to close the fascia layer during a laparotomy with a midline incision?

The choice of suture for closing the fascia layer during a laparotomy with a midline incision revolves around the properties required for optimal healing and support of the tissue. The fascia is a dense connective tissue that requires a strong suture material to withstand tension and provide stability as the incision site heals.

PDS, or polydioxanone, is a synthetic absorbable suture material that has a high tensile strength and is used commonly for deep tissue closures, including fascial layers. It maintains its strength longer than many other absorbable sutures, allowing for adequate healing time before it fully absorbs. This characteristic makes PDS particularly suitable for fascia, which undergoes significant tension and stress as the abdomen expands and contracts.

Using PDS helps minimize the risk of dehiscence (opening of the wound) and supports the tissue integrity during the critical healing period. Other suture materials may not provide the same level of tensile strength or may absorb too quickly, which could compromise the closure of the fascia during its healing process.