Elective and emergent laparotomy closure: The importance of protocolizing the technique

Abstract

Background: Incisional hernias are a frequent complication, and their prevention includes proper closure of the abdominal wall.

Methods: A prospective study was conducted at a third-level hospital after the introduction of a midline laparotomy closure protocol. An objective measurement of the suture length to incision length ratio was made. and the postoperative results were analyzed.

Results: 127 patients were included and 34 of them (26.8%) had received a technically deficient closure. Incisional hernia was described in 20.5% of cases. An improvement in the quality of the abdominal wall closure was demonstrated over time.

Conclusion: The abdominal wall closure was deficient in nearly one- quarter of the laparotomies performed at a third-level medical center. A protocol improved the quality of the laparotomy closure.

Keywords: Cierre primario; Hernia incisional; Incisional hernia; Incisional hernia prevention; Laparotomía media; Midline laparotomy; Prevención de la hernia incisional; Primary closure; SL:WL ratio.