Trial reportHernia : the journal of hernias and abdominal wall surgery2022
Prevention of incisional hernia with a reinforced tension line (RTL) versus primary suture only in midline laparotomies: 3-year follow-up in a randomized clinical trial.
Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers, 3 of them syntheses that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Posincisional Hernia Prevention. Effectiveness of Reinforced Tension Line (RTL) Technique Compared With the Conventional Method
Development and Internal Validation of a Machine Learning Model to Predict the Occurrence of Incisional Hernia After a Midline Laparotomy
Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Comparative Outcomes of Reinforced Tension-Line Sutures Versus Standard Closure Techniques in Patients Undergoing Laparotomy: A Systematic Review and Meta-Analysis.ANZ journal of surgery · 2026Pooled it
- Surgical site occurrence after prophylactic use of mesh for prevention of incisional hernia in midline laparotomy: systematic review and meta-analysis of randomized clinical trials.Surgical endoscopy · 2024Pooled it
- Abdominal wound dehiscence and incisional hernia prevention in midline laparotomy: a systematic review and network meta-analysis.Langenbeck's archives of surgery · 2023Pooled it
- Reinforced tension-line suture after laparotomy: long-term results of Rein4CeTo1 randomized clinical trial.BJS open · 2025Trial
- The MESH-RTL Project for prevention of abdominal wound dehiscence (AWD) in high-risk patients: noninferiority, randomized controlled trial.Surgical endoscopy · 2024Trial
- Reinforced tension-line suture after laparotomy: early results of the Rein4CeTo1 randomized clinical trial.The British journal of surgery · 2024Trial
- Botulinum toxin, progressive pneumoperitoneum and RTL closure for ventral hernias secondary to giant omphalocele in children: a 10-patient series.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Analysis of morphological patterns in incisional hernias following different surgical approaches.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Incisional hernia prediction using machine learning models.BMC medical informatics and decision making · 2026Observational
- [Reinforced fascial suture after midline laparotomy-The Rein4CeTo1 trial].Chirurgie (Heidelberg, Germany) · 2025Article
- Suture Techniques and Materials for Fascial Closure of Abdominal Wall Incisions: A Comprehensive Meta-Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Outcomes of elective and emergency surgical repair of incisional hernia: a comparative observational study.Hernia : the journal of hernias and abdominal wall surgery · 2024Observational
- Safety and efficacy revisited: a systematic review and meta-analysis of glue versus tack mesh fixation in laparoscopic inguinal herniorrhaphy.Frontiers in surgery · 2024Review
- Review
- Abdominal Closure With Reinforcing Suture Decreases Incisional Hernia Incidence After CRS/HIPEC.Journal of abdominal wall surgery : JAWS · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIncisional hernia (IH) has an incidence of 10-23%, which can increase to 38% in specific risk groups. The objective of this study is to report the results at 3 years of follow-up of the use of the reinforced tension line (RTL) technique compared with primary suture only (PSO) closure in the prevention of IH in high-risk patients undergoing laparotomy.
methodsOpen randomized controlled clinical trial. Included were patients older than 18 years who underwent midline laparotomy, emergency or scheduled, who were considered high risk, and who completed 3-year follow-up. The patients were randomized 1:1 to the RTL technique or to PSO. The objective was to report the incidence of IH and the complications associated with the closure method. Intention-to-treat analysis and Cox regression were performed.
resultsA total of 124 patients were randomized; 51 patients from the RTL group and 53 patients from the PSO group finished the 3-year follow-up. The incidence of IH was higher in the PSO group (15/53, 28.3%) than the RTL group (5/51, 9.8%) (p = 0.016, OR 0.35, 95% CI 0.14-0.88, number needed to treat 5.4, log-rank test p = 0.017). The groups were similar in the rates of surgical site infection, hematoma, seroma, and postoperative pain during follow-up.
conclusionsThe RTL technique is useful in the prevention of IH when compared with PSO in high-risk midline laparotomy patients, and it is not associated with a higher percentage of complications.
trial registrationLocal Committee CI-HRAEB-2013-020. March 13, 2013. CLINICAL TRIALS: NCT02136628, retrospectively registered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.