An evaluation of abdominal wall closure in general surgical and gynecological residents

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 21; no. 6; pp. 873 - 877
• Main Authors: Williams, Z., Williams, S., Easley, H. A., Seita, H. M., Hope, W. W.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.12.2017; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Abdominal wall; Medicine; Medicine & Public Health; Original Article; Surgery; Sutures; Wounds; Closure; Fascial; Abdominal; Education; Teaching
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-017-1682-z

Purpose To evaluate abdominal wall closure knowledge base and technical skills in surgical and OB/GYN residents. Methods Residents consented to participate in a skills laboratory and quiz. The skills portion involved closure of a 10-cm incision on a simulated abdominal wall. Participants were timed, filmed, and graded using a standardized grading system. Results Thirty surgical and OB/GYN residents participated. All residents reported closing the abdominal wall continuously, 97% preferred slowly absorbing sutures (28/29), 97% preferred taking 1-cm bites (29/30), and 93% spaced bites 1 cm apart (27/29). However, 77% (10/13) of surgery residents identified 4:1 as the ideal suture to wound length ratio; 47% (7/15) of OB/GYN residents believed it to be 2:1, and another 40% (6/15) indicated 3:1 ( p  < 0.0001). In the simulation, OB/GYN residents used significantly fewer stitches ( p  = 0.0028), significantly more distance between bites ( p  < 0.0001), and significantly larger bite size ( p  < 0.0001) than surgery residents. When graded, there was no significant difference between programs. Conclusions Despite some knowledge regarding the principles of abdominal wall closure among surgical and OB/GYN residents, more instruction is needed. We identified some differences in knowledge base and techniques for abdominal wall closure among general surgery and OB/GYN residents, which are likely due to differences in educational curriculums.