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Technique of Midline Abdominal Incision Closure Among Surgical and Obstetrics and Gynaecology Residents at a Kenyan Tertiary Hospital

Muturi Alex, Kotecha Vihar, Pulei Ann, Maseghe Philip

University of Nairobi, Kenya​

Correspondence to: Dr. Alex Muturi, P.O Box 14523, Nairobi; email:​


Background: Technique of abdominal wall closure (AAWC) determines wound related surgical complications. Residents in obstetrics & gynaecology and surgery departments perform most midline abdominal wall closure; we lack data on how it’s being done. This study identifies abdominal wall closure techniques used. Objective: To determine technique of midline abdominal wall closure amongst residents at a Kenyan tertiary hospital. Methodology: Descriptive study carried out from October 2015 to May 2016. Results were presented as frequencies, tables and pie charts. Results: 71 (35 surgical, 36 Ob Gyn) residents at the hospital completed a self-administered questionnaire. Knowledge on midline abdominal closure was acquired from medical officers (58.6%) or consultants before residency (28.6%). Absorbable suture was preferred for clean wounds by 75% of residents. 70% used size 1 suture for fascial closure. Most residents 95.7% closed fascia in clean wound by continuous suturing. Interrupted suturing was preferred in contaminated and dirty wounds. Half of the residents in both groups would close skin in contaminated wounds while 16% of surgery residents and 9.4% Ob Gyn will close skin in dirty wounds. Conclusion: There exists inconsistencies in anterior abdominal wall closure between groups of residents despite presence of clear guidelines. It’s important to harmonize the training on AAWC at the tertiary hospital.

Key words: Fascia closure, Midline incision, Wound complications

Ann Afr Surg. 2019; 17(2):***


Conflicts of Interest: None

Funding: None

© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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