Use of Looped Monofilament Instead of Braided Suture in Orthopedic Fascial Closure

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The established method of closing fascia lata is with braided continuous sutures (eg, No. 1-Vicryl). The distal extent of the fascial incision often undermines the skin incision, hindering placement of the fascial anchoring knot. An assistant may be required for forceful retraction. Looped monofilament (eg, No. 1-PDS), with a blunt needle, allows easier fascial closure. One bite is taken through both sides of the fascia before passing the needle through the preformed loop, thus completing the anchoring stitch. No assistant is needed. Monofilament is cheap, readily available, may reduce infection and tissue reaction, and maintains tensile strength for longer than braided sutures.

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