Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P066: THE EFFECT OF SUTURE SIZE ON RESIDENT SUTURING TECHNIQUE DURING ABDOMINAL WALL CLOSURE
Jordan A Bilezikian, MD; Justin D Faulkner, MD; Alexander Smith, MD; Banks Osborne, BS; Frederic E Eckhauser, MD, FACS; William W Hope, MD, FACS; New Hanover Regional Medical Center
Proper abdominal wall closure for a midline laparotomy incision is necessary for incisional hernia prevention. Surgical residents often close midline fascia at the end of complex intra-abdominal cases and previous studies have demonstrated that their closure technique improves as surgical training progresses. However, there have not been any studies assessing the influence that suture size has on suture to wound length ratios.
Surgical residents in our program performed a standardized scenario in a skills laboratory setting. A simulation of the abdominal wall was presented with a midline defect and closure was timed using single stranded 1 PDS in an opposing fashion being tied in the middle. This was then performed on a second model using 2-0 PDS suture. The vertical distance between each bite was measured on each side as well as the horizontal distance between each bite and the midline. Regression analysis was performed for each resident’s closures and each PGY year was compared with one another. A p-value of <0.05 was considered significant.
Eleven surgical residents were included in this study. The average time for closure using 1 PDS was 3 minutes, 54 seconds and 4 minutes, 34 seconds using 2-0 PDS. As the training year increased, the time of closure trended towards decreasing. The average vertical and horizontal distance when closing with 1 PDS decreased from the junior residents to the senior residents. However, the vertical and horizontal distances when closing with 2-0 PDS were much more consistent across all training years. The average horizontal and vertical distances for 1 PDS were 0.70 cm and 0.65 cm, respectively. The average horizontal and vertical distances for 2-0 PDS were 0.52 cm and 0.52 cm, respectively.
Previous studies have explored how surgical technique affects suture to wound length ratio, but there is sparse data on how suture size affects suture to wound length ratios. The results of this study indicate that when closing abdominal wall fascia, junior residents take smaller bites with smaller sutures, however more senior residents take more equal and small bites regardless of suture size. Further study is warranted to assess the surgical technique of a larger group of junior residents and if there is a tendency, study should investigate if early education can correct this tendency.
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