Suturing Smarter: Closure of Midline Laparotomy Using Barbed Polydioxanone Versus Conventional Polydioxanone – A Randomized Controlled Study

Midline laparotomy is widely used in abdominal surgeries, and proper  abdominal wall closure is essential to prevent complications like surgical site infections, wound dehiscence, incisional  hernias, and prolonged hospital stays. Traditionally, absorbable mnofilament sutures like polydioxanone (PDS) have been used for closure. Barbed sutures, which self-anchor without knots, offer potential benefits such as even tension distribution  and reduced closure time. However, despite growing use, especially in laparoscopic and open procedures, there is limited high-quality evidence comparing barbed and traditional sutures—particularly in the Indian population. Concerns persist  about barbed sutures’ long-term durability, cost-effectiveness, and risk of tissue trauma. This study seeks to fill these gaps  through a rigorous randomized controlled trial