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Year : 2020  |  Volume : 3  |  Issue : 4  |  Page : 117-121

Incisional hernia formation can be reduced following hyperthermic intraperitoneal chemotherapy with increased suture length to wound length ratio fascial closure

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
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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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