To assess wound morbidity outcomes as surrogates for clinically relevant suture line ischemia between figure-of-eight and running sutures during open ventral hernia repair.
Approach:
Study Design: A retrospective analysis of the ACHQC registry was conducted for adult patients undergoing open ventral hernia repair with ≥ 10 cm defect width.
Inclusion Criteria: Patients with complete midline fascial closure, CDC Class 1 wound, and documented use of either figure-of-eight or running suture were included.
Outcome Measures: Primary outcome was surgical site occurrences (SSO) at 30 days; secondary outcome was recurrence at 1 year.
Statistical Analysis: Descriptive and univariate statistics were used, along with multivariable logistic regression to compare SSO rates.
Key Findings:
Figure-of-eight sutures are associated with successful primary fascial closure for defects ≥ 15 cm.
Concerns regarding ischemic effects of figure-of-eight sutures on wound healing are not well-supported by existing literature.
The updated 2022 guidelines for continuous suture closure are based on low-quality evidence.
Interpretation:
Limitations:
The association between SSO and suture line perfusion inadequacy is theoretical and not validated.
The study excludes cases involving complex surgical techniques that may affect wound morbidity.
Conclusion:
Further investigation is needed to clarify the clinical significance of suture choice in ventral hernia repair.
by William C. Bennett, Alvaro C. Carvalho, Emerson Lora, Erika M. Schmidt, Noah X. Tocci, Ashley M. Mila-Hoff, Joseph Edwards, Cassandra Hennessy, Luciano G. Tastaldi, Lucas R. Beffa, David M. Krpata, Ajita S. Prabhu, Clayton C. Petro, Benjamin T. Miller
