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Session: ePoster: Quality and Cost 5 (Mon8)

EP977 - European Society of Coloproctology (ESCP) Projects on Harmonizing Surgical Abdominal Wound Closure and Surgical Site Infection Prevention Strategies in Colorectal-Surgery

Monday, May 12, 2025
8:32 AM – 8:37 AM PT
Location: Monitor 8, Sails Pavilion, Upper Level

    Presenting Author(s)

  • Muhammed Elhadi, MBBCh (he/him/his)

    Medical Doctor and Researcher in Training
    Department of Surgery, Houston Methodist Hospital
    Tripoli, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • GR

    Gabrielle van Ramshorst, MD FECSM FEBS FSSO

    Consultant colorectal surgeon
    Ghent University Hospital
    Ghent, Brussels Hoofdstedelijk Gewest, Belgium

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Ec

    European Society of Coloproctology (ESCP) collaborating group, n/a

    Collaborative Group
    ESCP
    Havant, England, United Kingdom

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Muhammed Elhadi, MBBCh: This individual has no financial relationships with ineligible companies.
Gabrielle van Ramshorst, MD FECSM FEBS FSSO: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The ESCP aims to investigate current midline closure techniques and practices for preventing surgical site infection (SSI).

Methods/Interventions: An online survey was distributed in 2021 asking surgeons to provide information on how they would close the abdominal wall in three specific clinical scenarios and on SSI prevention practices. The WOLVERINE study collects real-world data on abdominal wall closure and SSI prevention strategies. It consists of a first recruitment period conducted in 2023 and collects clinician-reported 30-day outcomes. A second recruitment period is currently being conducted, and patient-reported data will be collected for up to one year.

Results/Outcomes: A total of 561 consultants and trainee surgeons participated in the survey, mainly from Europe (n = 375, 66.8%). Of these, 60.6% identified themselves as colorectal surgeons and 39.4% as general surgeons. The majority used polydioxanone for fascial closure, with small bite techniques predominating in clean-contaminated cases (74.5%, n = 418). Most surgeons preferred 2% alcoholic chlorhexidine (68.4%) or aqueous povidone-iodine (61.1%) for skin preparation. The first recruitment period of WOLVERINE collected data from 1971 patients from 40 countries, including 379 (19.2%) who experienced complications, with 43.8% of these cases having unhealed wounds at 30 days and 9.2% presenting with incisional hernias, predominantly asymptomatic.

Conclusion/Discussion: Abdominal wound closure techniques and SSI prevention strategies vary widely between surgeons. There is little evidence of a risk-stratified approach to wound closure materials or techniques, with most surgeons using the same strategy for all patient scenarios. Harmonization of practice and the limitation of outlying techniques might result in better patient outcomes, and the data will be used to design an interventional randomized study in the near future.