Suture to wound length ratio in abdominal wall closure: how well are we doing?
| Autor: | Zachary F. Williams, W. B. Hooks, William W. Hope, P. Tenzel |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual medicine.medical_treatment Patient demographics Surgical Wound 030230 surgery Abdominal wall Young Adult 03 medical and health sciences Abdominal wall closure Postoperative Complications 0302 clinical medicine Suture (anatomy) Laparotomy Postoperative infection Humans Incisional Hernia Medicine Hernia Aged Retrospective Studies Aged 80 and over Sutures business.industry Abdominal Wall Internship and Residency Abdominal Wound Closure Techniques Middle Aged medicine.disease Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Female business Abdominal surgery |
| Zdroj: | Hernia. 21:869-872 |
| ISSN: | 1248-9204 1265-4906 |
| DOI: | 10.1007/s10029-017-1667-y |
| Popis: | Research has established that a ≥4:1 suture to wound (S:W) length ratio decreases incisional hernias. We evaluated our ability to obtain a 4:1 S:W length ratio in a surgery residency program. Consecutive abdominal wall closures from 12/1/2013 through 4/9/2015 were reviewed. The length of the incisions and amount of suture used were measured. Patient demographics and operative variables were documented and compared related to inability to obtain a 4:1 ratio. One hundred patients underwent abdominal closure with S:W length measurements. Average wound length was 18.3 cm; average suture length used was 84.5 cm; and average S:W length ratio was 4.6:1. An S:W length ratio of ≥4:1 was achieved in 76% of cases. There was no difference in race, age, gender, BMI, type of procedure, or resident level in obtaining a 4:1 S:W length ratio. There was a significantly higher rate of not achieving a 4:1 ratio when two residents closed. Postoperative infection rate and hernia rate increased when a 4:1 S:W length ratio was not achieved compared with an adequate S:W length ratio. Despite the known importance of achieving a 4:1 S:W length ratio for abdominal closure, it was only achieved in 76% of study patients. Improved education on the importance of fascial closure is needed. |
| Databáze: | OpenAIRE |
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