Elective and Emergent Laparotomy Closure: The Importance of Protocolizing the Technique

Abstract

BackgroundIncisional hernias are a frequent complication, and their prevention includes proper closure of the abdominal wall. MethodsA 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. Results127 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. ConclusionThe 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.