OC-109 ONE-YEAR FOLLOW-UP ANALYSIS OF WOUND VS SUTURE LENGTH RATIO AS A PREDICTOR OF INCISIONAL HERNIA - A COHORT STUDY (WISER)

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Abstract Background The purpose of the study was to determine if the recommended wound to suture length ratios of 1:4 and 1:6 were followed during midline laparotomy closure with loop PDS and 2–0 PDS, respectively, and whether this affected the development of an incisional hernia three years following the procedure. Methods This prospective study included eighty-six patients operated by the midline incision. The closures were performed as per the surgeon's choice. The length of the incision, types and length of suture used were noted. The one-year follow-up data was analyzed. Results In thirty cases, loop PDS was used for the closure, and in 56 patients, 2-0 PDS was used. Adherence to the recommendation was better with the loop PDS (13/30,43.33%) vs 2-0 PDS (8/56,14.28%). Eighteen patients were excluded(10-death-,5-loss to follow-up,3-reoperation).46.1%(12/26) developed incisional hernia in the loop PDS group vs 7.14%(3/42) with 2-0 PDS; total 22.05%(15/68). If the recommendations were followed or not, there were 20% (2/10) hernias in the loop PDS group compared to 62.5% (10/16); and 28.57% (2/7) compared to 2.8% (1/35) in the 2-0 PDS group. The loop PDS group had more malignancies (40% vs 20%, p=0.04). Conclusion The adherence to the recommendation of wound vs suture length was low. The incidence of incisional hernia was significantly low with 2-0 PDS, at one year, however the results should be interpreted with caution considering many patients closed with loop PDS had malignancies, a risk factor for incisional hernia, and low sample size due to death and loss to follow-up.