How to do an “Adelaide Tension Suture”

Abstract

Tension sutures are most often used after emergency midline laparotomy where the nature of the intra-abdominal pathology can lead to gut oedema with resultant difficulty in closure of the wound. They are primarily used for wounds thought to have an increased risk of dehiscence. The sutures are placed 3-5cm apart and are inserted to encompass a large amount of fascial tissue. Their use is controversial as they can be uncomfortable for the patient and often result in a poor cosmetic effect (Figure 1, 2).