Trial reportThe British journal of surgery2022
Effects of the short stitch technique for midline abdominal closure on incisional hernia (ESTOIH): randomized clinical trial.
Trial report in The British journal of 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 21 papers, 2 of them syntheses that pooled 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.
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.
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
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 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 during fascial closure of midline laparotomies: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2024Pooled it
- 5-year clinical outcome of the ESTOIH trial comparing the short-bite versus large-bite technique for elective midline abdominal closure.Hernia : the journal of hernias and abdominal wall surgery · 2025Trial
- Three-year follow-up analysis of the short-stitch versus long-stitch technique for elective midline abdominal closure randomized-controlled (ESTOIH) trial.Hernia : the journal of hernias and abdominal wall surgery · 2024Trial
- 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
- Article
- Genetic Susceptibility to Incisional Hernia Evaluation of Hernia Polygenic Risk Scores.medRxiv : the preprint server for health sciences · 2026Article
- Small-bite versus conventional midline fascial closure in abdominal surgery: a prospective observational cohort study.BMC surgery · 2026Observational
- Outcomes Following Implantation With Mesh Suture: A Registry of 1111 Patients.Plastic and reconstructive surgery. Global open · 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
- Article
- The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Strength of small-bites abdominal wall closure using different suturing methods and materials in an experimental animal model.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement vs. primary suture only in midline laparotomies (PRIMA): long-term outcomes of a multicentre, double-blind, randomised controlled trial.The Lancet regional health. Europe · 2024Article
- [Incisional hernias: epidemiology, evidence and guidelines].Chirurgie (Heidelberg, Germany) · 2024Review
- A Prospective Randomized Controlled Trial Comparing Clinical Equivalence of PD Synth and PDS Polydioxanone Sutures.Cureus · 2023Article
- Review
- Defining High-Risk Patients Suitable for Incisional Hernia Prevention.Journal of abdominal wall surgery : JAWS · 2023Article
- Duramesh registry study: short-term outcomes using mesh suture for abdominal wall closure.Frontiers in surgery · 2023Article
- 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
Corrections and comments
- Commented on bySelf-plagiarism.2023
Authors and funding
16 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncisional hernia remains a frequent problem after midline laparotomy. This study compared a short stitch to standard loop closure using an ultra-long-term absorbent elastic suture material.
methodsA prospective, multicentre, parallel-group, double-blind, randomized, controlled superiority trial was designed for the elective setting. Adult patients were randomly assigned by computer-generated sequence to fascial closure using a short stitch (5 to 8 mm every 5 mm, USP 2-0, single thread HR 26 mm needle) or long stitch technique (10 mm every 10 mm, USP 1, double loop, HR 48 mm needle) with a poly-4-hydroxybutyrate-based suture material (Monomax®). Incisional hernia assessed by ultrasound 1 year after surgery was the primary outcome.
resultsThe trial randomized 425 patients to short (n = 215) or long stitch technique (n = 210) of whom 414 (97.4 per cent) completed 1 year of follow-up. In the short stitch group, the fascia was closed with more stitches (46 (12 s.d.) versus 25 (7 s.d.); P < 0.001) and higher suture-to-wound length ratio (5.3 (2.2 s.d.) versus 4.0 (1.3 s.d.); P < 0.001). At 1 year, seven of 210 (3.3 per cent) patients in the short and 13 of 204 (6.4 per cent) patients in the long stitch group developed incisional hernia (odds ratio 1.97, 95 per cent confidence interval 0.77 to 5.05; P = 0.173).
conclusionThe 1-year incisional hernia development was relatively low with clinical but not statistical difference between short and long stitches. Registration number: NCT01965249 (http://www.clinicaltrials.gov).
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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.