CLosure of Abdominal MidlineS Survey (CLAMSS): A national survey investigating current practice in the closure of abdominal midline incisions in UK surgical practice.

التفاصيل البيبلوغرافية
العنوان:	CLosure of Abdominal MidlineS Survey (CLAMSS): A national survey investigating current practice in the closure of abdominal midline incisions in UK surgical practice.
المؤلفون:	Messenger DE; Department of Coloproctology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK., Rajaretnam N; Department of Colorectal Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK., Slade DAJ; Department of Surgery, National Reference Centre for Intestinal Failure, Salford Royal NHS Foundation Trust, Manchester, UK.
مؤلفون مشاركون:	CLosure of Abdominal MidlineS Survey (CLAMSS) Collaborative, Abdominal Wall Subcommittees of the Association of Coloproctologists of Great Britain and Ireland (ACPGBI) and the British Hernia Society (BHS), The Dukes' Club
المصدر:	Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2024 Aug; Vol. 26 (8), pp. 1617-1631. Date of Electronic Publication: 2024 Jun 27.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 100883611 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1463-1318 (Electronic) Linking ISSN: 14628910 NLM ISO Abbreviation: Colorectal Dis Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Oxford, UK : Blackwell Science Ltd.,
مواضيع طبية MeSH:	Abdominal Wound Closure Techniques* , Practice Patterns, Physicians'/statistics & numerical data , Incisional Hernia/surgery , Surgical Mesh*, Humans ; United Kingdom ; Surveys and Questionnaires ; Surgeons/statistics & numerical data ; Suture Techniques ; Abdomen/surgery ; Female ; Male ; Elective Surgical Procedures/statistics & numerical data
مستخلص:	Aim: Incisional herniation (IH) is a frequent complication following midline abdominal closure with significant associated morbidity. Randomized controlled trials have demonstrated that the small bites technique (SBT) and prophylactic mesh augmentation (PMA) may reduce IH compared to mass closure techniques, but data are lacking on their implementation in contemporary surgical practice. This survey aimed to evaluate the use of the SBT and PMA and to identify factors associated with their adoption. Method: Between 22 January 2023 and 16 March 2023, consultant surgeons across the UK were asked to complete a 25-question survey on closure of an elective primary midline incision. Results: Responses were received from 267 of 675 eligible surgeons (39.6%) in 38 NHS Trusts. Respondents were evenly split between tertiary centres (47.6%) and district general hospitals (49.4%). SBT and PMA were used by 19.9% and 3.0% of respondents, respectively. Compared to other techniques, surgeons using the SBT were more likely to close the anterior aponeurotic layer only, use single suture filaments, 2-0 gauge sutures and sharp needle points and routinely dissect abdominal layers to aid closure (all p < 0.001). Attendance at lectures/conferences on SBT (p = 0.043) and basing practice on available evidence (p < 0.001) were independently associated with use of the SBT. The commonest barriers to adopting SBT were a perceived lack of evidence (23.8%) and belief that personal IH rates were low (16.8%). Conclusion: A minority of UK consultant surgeons have adopted the SBT or PMA. Practice change should be driven by more widespread dissemination of current evidence and procedural information. (© 2024 Association of Coloproctology of Great Britain and Ireland.)
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فهرسة مساهمة:	Investigator: S Basu; T Hammond; M Lee; N Smart; A Mehta; R Harries; BE Byrne; N Blencowe; S Pathak; D Layfield; N Rolls; A Sayers; A Siddika; O Warren; J Hodgkinson; J Bullock; S Chandler; A Ehsan; A Aljorf; K Mellor; N Ahmed; D Gumaa; M Butt; R Aseem; A Wallace; W Luffman; A Fairclough; R Smyth; P Kapsampelis; R Bailey; M Johnson; D Kumar; M Elhusseini; I Elabbasy; MR Iqbal; M Albendary; A Sherazi; G Zhou; E Elsey; G Lingam; N Lal; K Mallalieu; K Spellar; M Bennett; A Farooq; N Saiyara; H Eltyeb; R Clifford; A Tang; A Frank; A Thompson; S Cyclewala; P Sarmah; A Ahmed; H Byrne; J Stringer; E Walker; L Smith; R Reid Keywords: abdominal closure techniques; abdominal wall; clinical practice pattern; cross sectional survey; incisional hernia; small bites technique
تواريخ الأحداث:	Date Created: 20240628 Date Completed: 20240820 Latest Revision: 20240820
رمز التحديث:	20240820
DOI:	10.1111/codi.17081
PMID:	38937910
قاعدة البيانات:	MEDLINE

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تدمد:	1463-1318
DOI:	10.1111/codi.17081