Background: The closure of the rectus sheath is essential in abdominal procedures to guarantee wound integrity, promote optimal healing, and avert problems such as wound dehiscence or incisional hernia. The choice of suture material profoundly affects postoperative results. 

Aim: This study aimed to compare wound healing and postoperative complications associated with 1-0 Vicryl and 1-0 Prolene sutures for rectus sheath closure in midline laparotomy.

Materials and Methods: A prospective comparative study was conducted on 60 patients undergoing elective midline laparotomy at a tertiary care center. The patients were randomly divided into two groups of 30 each. Group A underwent rectus sheath closure using 1-0 Vicryl, while Group B was closed with 1-0 Prolene. Standard surgical and aseptic techniques were followed in all cases. Postoperative assessment was done on days 3, 7, and 30, and subsequently at 3 and 6 months. Parameters assessed included postoperative pain, local wound infection, seroma or hematoma formation, wound dehiscence, and development of incisional hernia. Data were analyzed using appropriate statistical tests, and p-values <0.05 were considered significant.

Results: The average age of patients in the Vicryl group was 44.6 ± 12.3 years, while in the Prolene group it was 46.1 ± 11.7 years, with no significant demographic disparity. Postoperative pain levels were marginally elevated in the Prolene group throughout the initial postoperative phase. The occurrence of wound infection was 10% in the Vicryl group and 13.3% in the Prolene group, indicating no statistically significant difference. Seroma development was observed in 6.6% of Vicryl cases and 10% of Prolene cases. Partial wound dehiscence occurred in 2 cases (6.6%) within the Vicryl group and in 3 cases (10%) within the Prolene group. At the six-month follow-up, one instance of incisional hernia (3.3%) was documented in the Vicryl group, but two instances (6.6%) were noted in the Prolene group. Wound healing was acceptable in both groups, exhibiting identical complication rates; however, Vicryl demonstrated somewhat superior tissue integration and reduced postoperative pain.

Conclusion: Both 1-0 Vicryl and 1-0 Prolene are efficacious materials for rectus sheath closure, exhibiting comparable rates of wound healing and postoperative complications. Vicryl exhibited superior patient comfort and reduced postoperative pain, whilst Prolene provided extended tensile strength. 

KEYWORDS: Prolene, Rectus Sheath Closure, Suture Material, Vicryl, Wound Healing.