ArticleHernia : the journal of hernias and abdominal wall surgery2022
Standardized suturing can prevent slackening or bursting suture lines in midline abdominal incisions and defects.
Article 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. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of facial defect closure and non-fascial closure in ventral hernia repair: A systematic review and Meta-analysis of randomized controlled trials with trial sequential analysis.Hernia : the journal of hernias and abdominal wall surgery · 2026Pooled it
- 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
- Laparoscopic Suitcase Technique for lateral incisional hernias enables fully laparoscopic fascial closure: a retrospective comparative study.BMC surgery · 2026Article
- A virtual simulation study of the effects of laparotomy incision location and wound stiffness on abdominal wall mechanics.Scientific reports · 2025Article
- Experience sharing on perioperative clinical management of gastric cancer patients based on the "China Robotic Gastric Cancer Surgery Guidelines".Perioperative medicine (London, England) · 2024Review
- STRONGHOLD first-year results of biomechanically calculated abdominal wall repair: a propensity score matching.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- [Incisional hernias: epidemiology, evidence and guidelines].Chirurgie (Heidelberg, Germany) · 2024Review
- The Best Closure Technique Without Mesh in Elective Midline Laparotomy Closure.Journal of abdominal wall surgery : JAWS · 2022Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIncisional hernias often follow open abdominal surgery. A small-stitch-small-bite suture might close the incision durably. We analyzed specific details of this closure technique and assessed their influence on the closure stability.
methodsThe effects of cyclic loads, simulating coughs were investigated on a bench test. We prepared porcine bellies in the median line and bovine flanks parallel to the muscle fibers with 15 cm long incisions. Then we punched round or rhomboid defects with a diameter of 5-10 cm into the center of the incision. Monomax® 2-0 and Maxon® 1 and 2-0 were used as suture materials. We tested the durability of the closure with pressure impacts of 210 mmHg repeated 425 times. Throughout the experiments, we modified the suturing technique, the surgeon, the tissue tension, the defect size and shape and the suture diameter.
resultsStandardizing the suture technique improved the durability of the closure significantly. Any other variations showed minor influences after standardization. All incisions with round defects up to 7.5 cm width withstood 425 impacts using standardized suturing. Unstandardized sutures failed in all cases. When closing an incision with a 10 cm wide defect, the tissues ruptured frequently next to the suture line. We defined criteria to standardize this suturing technique. For the first time, we developed a suture factor related to the durability of a sutured tissue closure. We integrated the suture factor into the concept of biomechanically durable repairs.
conclusionsSuturing the abdominal wall with a standardized suturing technique improves its durability significantly.
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