P-037 ABDOMINAL WALL CLOSURE WITH SMALL-BITES TECHNIQUE USING PDS 3–0 SUTURE: EXPERIENCE IN A THIRD-LEVEL HOSPITAL

Abstract

Abstract Aim Current studies show the correct closure of the abdominal wall must be carried out with a technique of giving many points and separated from each other with very little distance (small-bites technique) and with a suture of slow absorption.We conducted a review of our experience in abdominal wall closure in which we used a 3–0 polydioxanone (PDS®II)-suture using small-bites technique. Methods Retrospective study analyzing our database of patients in whom laparotomy and abdominal wall closure were performed using small-bites with PDS 3–0 suture, needle 26mm-½C, during November-2018 to October-2020.Emergency and elective laparotomies were analyzed. Results 164 patients were analyzed(men:59.8%,age:73(IQR:61–78years)).LOS:6(IQR:5–10days). Pathological history: diabetes mellitus (28%), arterial hypertension (62.2%), dyslipidemia(67.1%), smoking (45.1%), alcohol consumption(19.5%), cardiovascular disease(19, 5%).BMI:27.45±4.2kg/m2(Range:18.31–38.29).Overweight:70.7%. Obesity:28%. Laparotomy location: midline(47.6%), pfannenstiel(30.5%), transverse or subcostal(22%). Laparotomy was performed as an auxiliary to laparoscopy in 35.4%. Emergency surgery:40.2%. Neoplasms:56.1%. Associated with hernia repair:17.1%. Associated with surgical reoperations:9.8%. Complications: no evisceration, SSI(11%),no eventration until current follow-up (17.5±4.3months). Overweight patients and those who underwent emergency surgery had a higher incidence of SSI (13.6% vs. 4.2% p=0.07; 18.2% vs. 6.1% p=0.015).The location of the laparotomy, the association with hernia repair, reoperations, and neoplasms were not associated with a higher incidence of SSI (p>0.05). Conclusions The closure of the abdominal wall using small-bites technique with slow resorption suture (PDS®II 3–0) with a small needle, provides a safe and effective closure, both in midline and transverse laparotomies, in emergency surgery and in patients with associated neoplasms, without increasing the number of complications and with no evidence of evisceration or eventrations.