ReviewFrontiers in surgery2022
Don't fear the (small) bite: A narrative review of the rationale and misconceptions surrounding closure of abdominal wall incisions.
Review in Frontiers in surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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.
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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.
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Who cites it
11 citing papers in PubMed.
- Unsupervised Clinical Phenotyping Identifies Distinct Risk Profiles in Incisional Hernia Repair.Medicina (Kaunas, Lithuania) · 2026Article
- Continuous fascial closure using absorbable barbed sutures lowers the risk of incisional hernia after minimally invasive colorectal surgery: a consecutive single-surgeon retrospective cohort study.Surgical endoscopy · 2026Article
- Small-Bite Versus Large-Bite Closure for the Prevention of Incisional Hernia: A Meta-Analysis.Cureus · 2026Review
- Small-bite versus conventional midline fascial closure in abdominal surgery: a prospective observational cohort study.BMC surgery · 2026Observational
- Intraoperative Fascial Traction - From Concept to Comprehensive Application.Journal of abdominal wall surgery : JAWS · 2026Review
- 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
- A Comparison of Tissue Handling Forces Between a Novel Suturing Device for Standardised Abdominal Wall Closure and Manual Needle-Driver Suturing.Journal of abdominal wall surgery : JAWS · 2025Article
- Clinical Outcomes Among Patients Undergoing Open Abdominal or Orthopedic Surgery with Wound Closure Incorporating Triclosan-Coated Barbed Sutures: A Multi-Institutional, Retrospective Database Study.Medical devices (Auckland, N.Z.) · 2025Article
- Advances and Techniques in Subcuticular Suturing for Abdominal Wall Closure: A Comprehensive Review.Cureus · 2024Review
- Prophylactic Mesh Augmentation of Midline Closure in Patients Undergoing Resection for Upper Gastrointestinal Cancer Reduces the Rate of Incisional Hernia: Results of a Case-Series Study.Journal of abdominal wall surgery : JAWS · 2024Article
- Low incisional hernia incidence using a large-bite, low-tension technique for celiotomy closure.Surgery open science · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The most common complications related to the closure of abdominal wall incisions are surgical site infections, wound dehiscence and the development of an incisional hernia. Several factors relating to the surgical technique and the materials used have been identified and analysed over the years, as mirrored in the current recommendations of the European Hernia Society, but some misconceptions still remain that hinder wide implementation. Method: A literature search was performed in the PubMed and GoogleScholar databases on 15 July 2021 and additionally on 30 March 2022 to include recent updates. The goal was to describe the scientific background behind the optimal strategies for reducing incisional hernia risk after closure of abdominal wall incisions in a narrative style review. Results: An aponeurosis alone, small bites/small steps continuous suture technique should be used, using a slowly resorbable USP 2/0 or alternatively USP 0 suture loaded in a small ½ circle needle. The fascial edges should be properly visualised and tension should be moderate. Conclusion: Despite the reproducibility, low risk and effectiveness in reducing wound complications following abdominal wall incisions, utilisation of the recommendation of the guidelines of the European Hernia Society remain relatively limited. More work is needed to clear misconceptions and disseminate the established knowledge and technique especially to younger surgeons.
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