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.