[Results of abdominal wall closure using the 4:1 suture/wound lenght technique]
Carlos Alberto Córdova-Velázquez1, Enrique Jesús Rodríguez-Espino1, Juan Manuel Martín-Bufajer1
1Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Departamento de Cirugía General. Ciudad de México, México.
Background:
Laparotomy is a daily procedure for the general surgeon and its main complication is the formation of hernias.
Objective:
To determine if the suture length to wound length ratio 4:1 for wall closure decreases the incidence of hernia.
Material And Methods:
Data from patients (n = 86) in whom abdominal wall closure was performed from August 2017 to January 2018 were prospectively reviewed. Patients who could not undergo adequate follow-up, those managed with open abdomen, or those with use of non-absorbable suture materials were excluded. 2 groups were formed: in one, the suture length to wound length ratio 4:1 technique was used as wall closure, and in the other it was used conventional suture; the length of the wound-suture length was measured, and the follow-up was post-surgical. For statistical analysis it was used descriptive statistics and inferential statistics (chi-squared and Mann-Withney's U).
Results:
The 2 groups had similar characteristics in all the inclusion criteria. There was a statistically significant difference in dehiscence and hernias. For both complications, the 4:1 suture is a protective factor. For the first it was obtained: p = 0.000, relative risk (RR) 0.114 with 95% confidence interval (95% CI) 0.030-0.437, and for the second, p = 0.000, RR .091, 95% CI 0.027-0.437.
Conclusions:
Abdominal wall closure using 4:1 suture/wound length was shown to decrease the incidence of hernia.
