A Preliminary Survey on the Knowledge and Technique of Midline Abdominal Wall Closure among General Surgeons

Jose Macario V. Faylona

Department of Surgery, College of Medicine and Philippine General Hospital,
University of the Philippines Manila

Objective. This preliminary survey aims to determine the depth of knowledge and preference for technique in midline abdominal wall closure among general surgeons.

Methods. A random survey among general surgeons was done during the Philippine College of Surgeons Annual Convention last December 2013. The results were analyzed and compared with published literature on abdominal wall closure and the proper technique of closure.

Results. There were 36 respondents: 17 (48.6%) residents and 18 (51.4) consultants, 85.7% of whom said they learned closure as taught by their seniors or consultants, 82.8% said they close the abdomen using a continuous suture technique and 57.1% said they apply an interlocking stitch. The most popular suture material used for closure is an absorbable suture with long dissolution time (71.4%). 51.4% put their sutures at 5-9 mm intervals and 40% put the structures at 5-9 mm or 1 cm or more from the edge of the wound. 51.4% close the subcutaneous tissue and 94.2% do not place subcutaneous drains.

Conclusion. In this preliminary survey, both consultants and residents learned closure by being taught by their seniors. Knowledge and techniques of closure were adequate but were inconsistent with reported literature. This demonstrates a possible inadequacy in the knowledge and skills training with regard to midline laparotomy closure.

Key Words: laparotomy, abdominal would closure techniques, survey