| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 3
| Issue : 4 | Page : 117-121 |
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Incisional hernia formation can be reduced following hyperthermic intraperitoneal chemotherapy with increased suture length to wound length ratio fascial closure
Joseph A Lewcun, Eric M Pauli, Colette Pameijer
Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, USA
Correspondence Address:
Dr. Colette Pameijer
Penn State Hershey College of Medicine and Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033
USA
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijawhs.ijawhs_30_20
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INTRODUCTION: Incisional hernia (IH) is a common postsurgical complication of laparotomy. The impact of hyperthermic intraperitoneal chemotherapy on fascial healing has not been evaluated. The aim of this study is to determine whether utilizing a 4:1 suture length to wound length ratio (SL:WL) during fascial closure reduces the risk of IH following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS-HIPEC).
METHODS: A retrospective review of patients who underwent HIPEC between 2013 and 2019 at a single institution was performed. Demographics and IH rates were compared between patients closed with a 4:1 SL:WL and patients with standard fascial closure (SFC). Hernias were detected on physical examination or on cross-sectional imaging studies.
RESULTS: Eighty-six patients who underwent HIPEC were included in the study. A 4:1 SL:WL was utilized in 26.7% (n = 23) of HIPEC cases and the remaining 73.3% (n = 63) of patients received SFC methods. Three patients in the 4:1 SL:WL group developed hernias, whereas 22 patients in the SFC group had hernias (13.0% vs. 34.9%, P = 0.048). The incidence of IHs was similar across the body mass index, smoking status, and operative time categories.
CONCLUSION: Utilizing a 4:1 SL:WL during fascial closure may reduce the rates of IH in the HIPEC population, but larger sample sizes and longer follow-up are required to determine the statistical significance of this intervention.
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