***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background The closure of the abdomen after  median laparotomy  is still a matter of debate among surgeons . Further well design ed and performed r and omised controlled trials determining the optimal method of abdominal fascial closure are needed . Design This is a three armed , multi-centre , intra-operatively r and omised , controlled , patient blinded trial . Over 20 surgical departments will enrol 600 patients who are planned for an elective primary abdominal operation . The objective of this study is to compare the frequency of abdominal incisional hernias between two continuous suture techniques with different , slowly absorbable monofilament material s and an interrupted suture using an absorbable braided suture material at one year postoperatively . Conclusion This trial will answer the question whether the continuous abdominal wall closure with a slowly absorbable material with longitudinal elasticity is superior to the continuous suture with a material lacking elasticity and to interrupted sutures with braided thread A r and omized parallel-group clinical trial was conducted between March 1991 and December 1993 to compare the effectiveness of subcuticular suture using absorbable material ( Dexon ) and continuous transdermal blanket suture using nonabsorbable material ( silk ) in hip surgery .  Eighty patients ( 48 females and 32 males ) aged between 19 and 94 years ( average 71.4 years ) who underwent 97 hip operations were studied . Patients were followed up between 2 and 20 months . The two groups were evaluated with respect to infection rate , patient satisfaction with the scar , extra time and cost in removal of suture and the cosmetic appearance assessed by a plastic surgeon evaluating photos of patients ' wounds using a specific scoring method without knowledge of the suturing method used . Five patients died  during the study . There was no significant difference in superficial infection rate between the two groups ( 5 % with positive bacteriological swab and 16 % requiring extra antibiotics on clinical grounds ) . No deep infection was suspected in either group . The average score of patient satisfaction with the scar was 9.6/10 in the subcuticular group and 8.68/10 in the continuous mattress with a significant difference between the two groups ( p < 0.05 ) . Cosmetic evaluation by the plastic surgeon using a 6-category scoring system showed a better cosmetic result in the subcuticular group with a significant difference ( p < 0.01 ) . An average of 17 minutes of extra nursing time was needed for removal of suture material in the nonabsorbable group in addition to the cost of the suture removal set . We conclude that absorbable subcuticular skin closure is an effective method and offers some advantages over the traditional transdermal suturing method in hip surgery BACKGROUND Recently , a number of laparoscopic port-closure techniques have been reported to avoid the complications associated with the port closure after laparoscopic surgery . To evaluate these port-closure techniques , we compared seven new laparoscopic port-closure techniques with the st and ard technique of a h and -sutured closure . STUDY DESIGN In a prospect i ve , r and omized study , 95 , 12-mm port sites in 32 patients undergoing transperitoneal laparoscopic procedures were r and omized to one of eight different port-site closure techniques . The port-closure techniques included : the Carter-Thomason Needle-Point Suture Passer , Maciol suture needle set , eXit Disposable Puncture Closure device , Endoclose suture carrier , Tahoe Surgical Instruments Ligature device , a long 14-gauge angiocatheter with looped polypropylene suture , Lowsley retractor with h and -sutured closure , and the st and ard technique of h and -sutured closure . We evaluated the time , the security , and the auxiliary instrumentation required for each closure . RESULTS Of the port-closure techniques , the Carter-Thomason device was faster overall , result ed in fewer port-closure-related complications and provided a leak proof closure . CONCLUSIONS The Carter-Thomason device is our preferred method for the closure of port sites after laparoscopic surgery Op-Site skin closure was compared with two st and ard techniques of wound closure , interrupted silk sutures and subcuticular nylon . The Op-Site skin closure allowed freer drainage of secretions from the wound and the incidence of erythema and tenderness was significantly lower . However , there was a greater tendency for the wound edges to slip out of alignment or invert BACKGROUND There is long-st and ing disagreement among facial plastic surgeons as to the ideal suture material for closing skin wounds of the face . Many surgeons believe that nonabsorbable suture material is preferable , as it is easier to tie , is unlikely to break prematurely , and elicits a minimal inflammatory response . Others feel that these issues are of minor importance and prefer absorbable sutures because they do not have to be removed , thus saving the surgeon time and decreasing patient anxiety and discomfort . PATIENTS AND METHODS Facial skin cancers were removed from 41 patients . The length of closure ranged from 3.5 to 12.0 cm . All wounds were closed with rotational advancement flaps . Deep tissues were closed with 4 - 0 poliglecaprone 25 ( Monocryl ; Ethicon Inc , Somerville , NJ ) . One half of each wound was r and omly closed with 5 - 0 coated polypropylene ( Prolene ; Ethicon Inc ) , while the other half was closed with 5 - 0 coated irradiated polyglactin 910 ( Vicryl Rapide ; Ethicon Inc ) . No wound infections or premature rupture of sutures occurred . All patients were followed up for 6 months after surgery . The photographs of the results were review ed , and no difference was noted in scar formation . CONCLUSIONS In adults with clean wounds of the face or neck , there is no difference in long-term cosmetic results of repairs with permanent or absorbable suture material . We prefer absorbable sutures , as they do not have to be removed , saving the surgeon time and lessening patient anxiety and discomfort A prospect i ve , r and omized trial was performed to compare the incidence of wound infection following skin closure with subcuticular polyglycolic acid and interrupted monofilament nylon mattress sutures in patients undergoing high saphenous ligation ( 126 patients ; 75 polyglycolic acid wounds , 86 interrupted monofilament nylon mattress wounds ) . By 6 weeks after operation , pus had discharged from 15 ( 20 % ) polyglycolic acid wounds compared with seven ( 8 % ) interrupted monofilament nylon mattress wounds ( P = 0.05 ) , giving an overall infection rate of 13.7 % . Infection occurred in 23 % of the 56 procedures performed by the two surgeons with the highest infection rates compared with 8 % of the 105 procedures performed by the remaining nine surgeons ( P = 0.02 ) . The excess of infections in wounds closed with subcuticular polyglycolic acid was caused by an excess of infections in operations performed by the two surgeons with the highest infection rates . The higher infection rate found with subcuticular polyglycolic acid appeared to be operator dependent Skin closure using continuous nylon sutures was compared with closure using interrupted nylon sutures in 105 consecutive patients undergoing laparotomy .  Particular note was made of wound healing and wound infection BACKGROUND There are no accepted guidelines for the closure of laparotomy incisions in patients of peritonitis . As these patients differ from the patients undergoing elective abdominal surgery , the same recommendations for closure may not be applicable in both groups . AIM To compare wound outcome parameters following closure of the laparotomy incision with absorbable and non-absorbable suture material using the continuous and interrupted techniques in patients of peritonitis . METHOD A single blinded r and omised controlled trial using Polygalactin-910 and Polypropylene , number 1 sutures , to close midline vertical incisions , placed in continuous and interrupted manner , was performed on 174 patients . Patients were r and omised into four groups : Group A ( Polygalactin-910 continuous suturing , n=40 ) , B ( Polygalactin-910 interrupted suturing , n=47 ) , C ( Polypropylene continuous suturing , n=45 ) and D ( Polypropylene interrupted suturing , n=42 ) . The incidence of wound infection , dehiscence , suture sinus formation and incisional hernia was recorded . Patients were followed up for a period of four years . Statistical analysis involved the chi-square and Fisher 's exact tests . A ' p ' value of < 0.05 was considered significant . RESULTS The study included 139 male and 35 female patients between the ages of 10 and 75 years . The incidence of wound infection ( p=0.656 ) , dehiscence ( p=0.997 ) , and incisional hernia ( p=0.930 ) at 3 months and four years ( p= 0.910 ) was not statistically significant . There was no sinus formation in groups A and B , however 2 patients of group C and 6 patients of group D did develop suture sinus ( p=0.003 ) . CONCLUSION Suture material and technique of closure does not influence wound outcome in patients of peritonitis except for a significantly lower incidence of sinus formation when non-absorbable sutures are used Objectives : We sought to compare the long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for facial lacerations in children and to compare the complication rates and parental satisfaction in the 2 groups . Design / Methods : Healthy patients presenting to a pediatric emergency department with facial lacerations were r and omized to repair using fast-absorbing catgut or nylon suture . Patients were followed up at 5 to 7 days and at 3 months . Three blinded observers , using a previously vali date d 100-mm cosmesis visual analogue scale ( VAS ) as the primary instrument , rated photographs of the wound taken at 3 months . For this noninferiority study , a VAS score of 15 mm or greater was considered to be the minimal clinical ly important difference . Parents also rated the wound using the VAS and completed a satisfaction survey . Results : Of the 88 patients initially enrolled , 47 patients completed the study : 23 in the catgut group and 24 in the nylon group . There were no significant differences in age , race , sex , wound length , number of sutures , and layered repair rates in the 2 groups . The observers ' mean VAS for the catgut group was 92.3 ( 95 % confidence interval [ CI ] , 89.1 - 95.4 ) and that for the nylon group was 93.7 ( 95 % CI , 91.4 - 96.0 ) , with a difference of the means of 1.4 ( 95 % CI , −5.31 to 8.15 ) , which was less than the minimal clinical ly important difference of 15 mm ( power , > 90 % ) . The mean parental VAS score for the catgut group was 86.3 ( 95 % CI , 78.4 - 94.1 ) and that for the nylon group was 91.2 ( 95 % CI , 86.9 - 95.4 ) , with a difference of the means of 4.9 ( 95 % CI , 2.41 - 7.41 ) , also less than 15 mm . There were no significant differences in the rates of infection , wound dehiscence , keloid formation , and parental satisfaction . Conclusions : The use of fast-absorbing catgut suture is a viable alternative to nonabsorbable suture in the repair of facial lacerations in children BACKGROUND The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy . A secondary objective was to assess the incidence of surgical site infection ( SSI ) . METHODS Patients undergoing modified radical mastectomy were r and omly assigned to coated VICRYL Plus antibacterial ( Polyglactin 910 ) suture or Chinese silk suture .  Cosmetic outcomes were evaluated postoperatively at days 12 ( ± 2 ) and 30 ( ± 5 ) , and the evidence of SSI was assessed at days 3 , 5 , 7 , 12 ( ± 2 ) , 30 ( ± 5 ) , and 90 ( ± 7 ) . Cosmetic outcomes were independently assessed via visual analogue scale ( VAS ) score evaluations of blinded incision photographs ( primary endpoint ) and surgeon-assessed modified Holl and er Scale ( mHCS ) scores ( secondary endpoint ) . SSI assessment s used both CDC criteria and ASEPSIS scores . RESULTS Six Chinese hospitals r and omized 101 women undergoing modified radical mastectomy to closure with coated VICRYL Plus suture ( n = 51 ) or Chinese silk suture ( n = 50 ) . Mean VAS cosmetic outcome scores for antibacterial suture ( 67.2 ) were better than for Chinese silk ( 45.4 ) at day 30 ( P < 0.0001 ) ) . Mean mHCS cosmetic outcome total scores , were also higher for antibacterial suture ( 5.7 ) than for Chinese silk ( 5.0 ) at day 30 ( P = 0.002 ) . CONCLUSIONS Patients using coated VICRYL Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures . Patients using coated VICRYL Plus s 
    Output:
    
The continuous suture technique with absorbable suture does not require suture removal and provides support for the wound for a longer period of time .
This may have contributed to the difference between the two groups in the proportion of participants who developed superficial wound dehiscence .
Superficial wound dehiscence may be reduced by using continuous subcuticular sutures .
Besides , the nature of the suture material used may have led to this observation , as the continuous suturing technique used suture material that did not need to be removed , whereas the comparator used interrupted ( non-absorbable ) sutures that did need to be removed .