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Suture to wound length ratio in abdominal wall closure: how well are we doing?

Publication ,  Journal Article
Williams, ZF; Tenzel, P; Hooks, WB; Hope, WW
Published in: Hernia
December 2017

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

December 2017

Volume

21

Issue

6

Start / End Page

869 / 872

Location

France

Related Subject Headings

  • Young Adult
  • Sutures
  • Surgical Wound
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laparotomy
  • Internship and Residency
 

Citation

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ICMJE
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Williams, Z. F., Tenzel, P., Hooks, W. B., & Hope, W. W. (2017). Suture to wound length ratio in abdominal wall closure: how well are we doing? Hernia, 21(6), 869–872. https://doi.org/10.1007/s10029-017-1667-y
Williams, Z. F., P. Tenzel, W. B. Hooks, and W. W. Hope. “Suture to wound length ratio in abdominal wall closure: how well are we doing?Hernia 21, no. 6 (December 2017): 869–72. https://doi.org/10.1007/s10029-017-1667-y.
Williams ZF, Tenzel P, Hooks WB, Hope WW. Suture to wound length ratio in abdominal wall closure: how well are we doing? Hernia. 2017 Dec;21(6):869–72.
Williams, Z. F., et al. “Suture to wound length ratio in abdominal wall closure: how well are we doing?Hernia, vol. 21, no. 6, Dec. 2017, pp. 869–72. Pubmed, doi:10.1007/s10029-017-1667-y.
Williams ZF, Tenzel P, Hooks WB, Hope WW. Suture to wound length ratio in abdominal wall closure: how well are we doing? Hernia. 2017 Dec;21(6):869–872.
Journal cover image

Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

December 2017

Volume

21

Issue

6

Start / End Page

869 / 872

Location

France

Related Subject Headings

  • Young Adult
  • Sutures
  • Surgical Wound
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laparotomy
  • Internship and Residency