Evidence map›Paper›PMID 34050419›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2022

Effects of the short-stitch technique for midline abdominal closure: short-term results from the randomised-controlled ESTOIH trial.

M Albertsmeier, A Hofmann, P Baumann, S Riedl, C Reisensohn, J L Kewer, J Hoelderle, A Shamiyeh, B Klugsberger, T D Maier and 5 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

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 trial NCT01965249 (Short Stitch Versus Long Stitch Suture Technique Using Monomax® for Abdominal Wall Closure After Primary Median Laparotomy. A Randomized, Controlled, Double-blinded, Multicenter, International Trial), which is not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT01965249 nacompletednot on this map

Short Stitch Versus Long Stitch Suture Technique Using Monomax® for Abdominal Wall Closure After Primary Median Laparotomy. A Randomized, Controlled, Double-blinded, Multicenter, International Trial

TypeinterventionalSponsorAesculap AGRan2014 to 2024Enrolled425ConditionsInjury of Abdominal WallArmsLong stitch, Short Stitch
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Pooled it
  2. 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 · 2025
    Pooled it
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  6. Trial
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  11. Observational
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  16. 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 · 2025
    Article
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  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 2 countries.

M AlbertsmeierDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, 81377, Munich, Germany.ORCID http://orcid.org/0000-0002-5028-5062
A HofmannAllgemein-, Viszeral- und Tumorchirurgie, Wilhelminenspital, Montleartstr. 37, 1160, Vienna, Austria.
P BaumannDepartment of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz, 78532, Tuttlingen, Germany.
S RiedlKlinik am Eichert, Allgemeinchirurgie, Alb Fils Klinik GmbH, Eichertstr.3, 73035, Göppingen, Germany.
C ReisensohnKlinik am Eichert, Allgemeinchirurgie, Alb Fils Klinik GmbH, Eichertstr.3, 73035, Göppingen, Germany.
J L KewerKlinik für Allgemein-, Viszeral- und Gefäßchirurgie, Klinikum Landkreis Tuttlingen, Zeppelinstr. 21, 78532, Tuttlingen, Germany.
J HoelderleKlinik für Allgemein-, Viszeral- und Gefäßchirurgie, Klinikum Landkreis Tuttlingen, Zeppelinstr. 21, 78532, Tuttlingen, Germany.
A ShamiyehKlinik für Allgemein- und Viszeralchirurgie, Kepler Universitätsklinikum GmbH, Krankenhausstr. 9, 4021, Linz, Austria.
B KlugsbergerKlinik für Allgemein- und Viszeralchirurgie, Kepler Universitätsklinikum GmbH, Krankenhausstr. 9, 4021, Linz, Austria.
T D MaierAllgemein- und Viszeralchirurgie, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Germany.
G SchumacherChirurgische Klinik, Städtisches Klinikum Braunschweig, Salzdahlumer Str. 90, 38126, Brunswick, Germany.
F KöckerlingKlinik für Chirurgie, Viszeral- und Gefäßchirurgie, Vivantes Klinikum Spandau, Neue Bergstr. 6, 13585, Berlin, Germany.
U PessionZentrum der Chirurgie, Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai, 60590, Frankfurt am Main, Germany.
M WenigerDepartment of General, Visceral and Transplantation Surgery, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, 81377, Munich, Germany.ORCID http://orcid.org/0000-0002-5178-8358
R H FortelnyAllgemein-, Viszeral- und Tumorchirurgie, Wilhelminenspital, Montleartstr. 37, 1160, Vienna, Austria. dr.fortelny@gmail.com.ORCID http://orcid.org/0000-0002-0066-7716
Alb Fils Kliniken · DEKepler Universitätsklinikum · ATLMU Klinikum · DEGoethe University Frankfurt · DEKlinikum Braunschweig · DERobert Bosch Hospital · DESigmund Freud Privatuniversität Wien · ATVivantes Klinikum · DEWilhelminen Hospital · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe short-stitch technique for midline laparotomy closure has been shown to reduce hernia rates, but long stitches remain the standard of care and the effect of the short-stitch technique on short-term results is not well known. The aim of this study was to compare the two techniques, using an ultra-long-term absorbable elastic suture material.

methodsFollowing elective midline laparotomy, 425 patients in 9 centres were randomised to receive wound closure using the short-stitch (USP 2-0 single thread, n = 215) or long-stitch (USP 1 double loop, n = 210) technique with a poly-4-hydroxybutyrate-based suture material (Monomax

resultsAt 30 (+10) days postoperatively, 3 (1.40%) of 215 patients in the short-stitch group and 10 (4.76%) of 210 patients in the long-stitch group had developed burst abdomen [OR 0.2830 (0.0768-1.0433), p = 0.0513]. Ruptured suture, seroma and hematoma and other wound healing disorders occurred in small numbers without differences between groups. In a planned Cox proportional hazard model for burst abdomen, the short-stitch group had a significantly lower risk [HR 0.1783 (0.0379-0.6617), p = 0.0115].

conclusionsAlthough this trial revealed no significant difference in short-term results between the short-stitch and long-stitch techniques for closure of midline laparotomy, a trend towards a lower rate of burst abdomen in the short-stitch group suggests a possible advantage of the short-stitch technique. TRIAL REGISTRY: NCT01965249, registered October 18, 2013.

Indexed as

Abdominal Wound Closure TechniquesAbdomenHerniorrhaphyHumansLaparotomySuturesSuture TechniquesBurst abdomenHumanRandomised-controlled trialShort stitchesSmall bitesSurgical site infection

Identifiers

PMID34050419
PMCPMC8881264
OpenAlexW3164132908

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.