ArticleHernia : the journal of hernias and abdominal wall surgery2020
Implementation of the small bites closure of abdominal midline incisions in clinical practice is correlated with a reduction in surgical site infections.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Impact of the SUture BIte TEchnique on clinical outcomes after midline laparotomy closure: SUBITE-a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2026Pooled it
- Small-bites versus large-bites closure of midline laparotomies: A systematic review and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Pooled it
- A postoperative body weight increase is a novel risk factor for incisional hernia of midline abdominal incision after elective gastroenterological surgery.Langenbeck's archives of surgery · 2023Trial
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- Small-Bite Versus Large-Bite Closure for the Prevention of Incisional Hernia: A Meta-Analysis.Cureus · 2026Review
- A feasibility and safety trial investigating a device for swift and standardized median laparotomy closure.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Variable use of modern abdominal wall closure techniques at emergency laparotomy - an international, cross-sectional survey of surgical practice.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- A literature-based cost-effectiveness analysis of device-assisted suturing versus needle-driven suturing during laparotomy closure.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
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- Article
- Does small bite closure reduce the incidence of incisional hernia compared to standard mass closure for midline laparotomy?Annals of medicine and surgery (2012) · 2022Article
- Introduction of Small Stitch Small Bite technique: a retrospective long-term follow-up.Langenbeck's archives of surgery · 2022Article
- Implementing a protocol to prevent incisional hernia in high-risk patients: a mesh is a powerful tool.Hernia : the journal of hernias and abdominal wall surgery · 2022Article
- Don't fear the (small) bite: A narrative review of the rationale and misconceptions surrounding closure of abdominal wall incisions.Frontiers in surgery · 2022Review
- Delphi Consensus on Intraoperative Technical/Surgical Aspects to Prevent Surgical Site Infection after Colorectal Surgery.Journal of the American College of Surgeons · 2022Article
- Systematic Review and Meta-Analysis of Wound Bundles in Emergency Midline Laparotomy Identifies That It Is Time for Improvement.Life (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSmall steps wound closure of midline laparotomy has been reported to decrease the incidence of incisional hernia development in two randomized controlled trials. The aim of the present study was to evaluate the effect of implementing the small steps wound closure technique in clinical practice with regards to the development of incisional ventral hernia (IVH) and surgical site infections (SSI) in clinical practice.
methodsImplementation of the small steps wound closure technique using the small tissue bites technique as the standard closure technique for abdominal midline incisions in our clinical practice was done in March 2015. For this study, all patients from June 2013 until June 2016 with a midline laparotomy, either long or small in case of specimen extraction in laparoscopic surgery, in either elective or emergency setting were included. Conventional large bite wound closure was compared to small steps wound closure with regards to the development of SSI, IVH as well as burst abdomen.
resultsA total of 327 patients were included. The small steps suture technique was used in 136 (42%) of the patients, whereas the conventional large bites suture technique was used in 191 patients (58%). A total of 54 patients in the large bites group developed SSI (28%) compared to 23 (17%) patients in the small steps group (p = 0.02). A total number of 10 patients (7%) developed IVH in the small steps group compared to 27 patients (14%) in the large bites group (p = 0.08).
conclusionImplementation of small bites wound closure of abdominal midline incisions in clinical practice was correlated with a reduction in surgical site infections.
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