Abdominal wall closure: How do we do it in Spain? Survey of specialist general surgeons members of the AEC (Spanish Society of Surgeons)

Abstract

Objectives

To evaluate the knowledge of abdominal wall closure in a cohort of specialist general surgeons who are members of the AEC and to see its adequacy with current recommendations. Sub-analysis in terms of years of specialization.

Material and methods

Individual questionnaire of 21 questions on abdominal wall closure in elective and urgent context.

Results

A total of 371 responses were received from specialist surgeons who are members of the AEC. Closure of the median laparotomy is performed with continuous suture in 99.7% and with slowly absorbable materials in 95.4%. 88.4% of surgeons report using the ratio equal to or greater than 4:1 between suture length and incision length (SL:IL) and short stitches. These results are equivalent in transverse and urgent elective laparotomy. 85.2% of the respondents systematically close trocars of 10 mm or more and 30.7% use prophylactic mesh in high-risk patients. Surgeons with less than 10 years of experience use the ratio ≥ 4:1 SL:SI and short stitches more than surgeons with more experience (93.4% vs 84.9%; P = .013).

Conclusions

Abdominal wall closure among general surgeons who are members of the ACS is adequate and adjusted to the recommendations with a tendency to improve among surgeons with less experience. There is an opportunity for improvement in the use of prophylactic mesh in high-risk patients.