SynthesisLangenbeck's archives of surgery2023
Abdominal wound dehiscence and incisional hernia prevention in midline laparotomy: a systematic review and network meta-analysis.
Synthesis in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 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
- Modified Smead-Jones suture for closure of emergency midline laparotomy incision: systematic review and meta-analysis.Updates in surgery · 2025Pooled it
- Incisional and parastomal hernias after harvesting of Vertical Rectus Abdominis Myocutaneous (VRAM) flaps: incidence, treatment options and outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2025Pooled it
- The MESH-RTL Project for prevention of abdominal wound dehiscence (AWD) in high-risk patients: noninferiority, randomized controlled trial.Surgical endoscopy · 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
- An inflammation-nutrition composite index and its dynamic change for predicting postoperative wound complications.Langenbeck's archives of surgery · 2026Observational
- A traction suture for abdominal wall closure in large incisional hernias: a prospective analysis of the "suitcase technique" - a simple horizontal offloading z-suture for gradual myofascial approximation.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Comparing incisional hernia risk between single-port and multiport robot-assisted partial nephrectomy: a retrospective analysis.Journal of robotic surgery · 2026Article
- External validation of the ACS NSQIP surgical risk calculator for the prediction of surgical site infection (SSI) and its association with the postoperative occurrence of incisional hernia (IH) in midline laparotomy patients.Langenbeck's archives of surgery · 2025Article
- The role of negative incisional pressure in the prevention of surgical site complications in patients with median incisional hernia.European journal of medical research · 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
- Risk Factors and Predictive Accuracy of the Rotterdam Risk Index for Wound Dehiscence Following Abdominal Surgery.Cureus · 2025Article
- The evaluation of risk factors in fascia dehiscence after abdominal surgeries.Annals of medicine and surgery (2012) · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncisional hernia (IH) is the main complication after laparotomy. In an attempt to reduce this complication, mesh techniques and studies in which the closure technique is modified have been proposed. Both types are characterized by comparison with the closure described as standard or conventional: 1 × 1, mass, and continuous closure. For this study, modified closure techniques (MCTs) were considered as those techniques in which an extra suture is placed (reinforced tension line (RTL), retention), the closure point is modified in distance (small bites) or shape (CLDC, Smead Jones, interrupted, Cardiff point) and which aim to reduce these complications. The objective of this network meta-analysis (NMA) was to evaluate the effectiveness of MCTs for reducing the incidence of IH and abdominal wound dehiscence (AWD) to provide objective support for their recommendation.
methodsAn NMA was performed according to the PRISMA-NMA guidelines. The primary objective was to determine the incidence of IH and AWD, and the secondary objective was to determine the incidence of postoperative complications. Only published clinical trials were included. The risk of bias was analyzed, and the random-effects model was used to determine statistical significance.
resultsTwelve studies comparing 3540 patients were included. The incidence of HI was lower in RTL, retention suture, and small bites, these techniques showed statistical differences with pooled ORs (95% CI) of 0.28 (0.09-0.83), 0.28 (0.13-0.62), and 0.44 (0.31-0.62), respectively. Associated complications, including hematoma, seroma, and postoperative pain, could not be analyzed; however, MCTs did not increase the risk of surgical site infection.
conclusionSmall bites, RTL, and retention sutures decreased the prevalence of IH. RTL and retention suture decreased the prevalence of AWD. RTL was the best technique as it reduced both complications (IH and AWD) and had the best SUCRA and P-scores, and the number needed to treat (NNT) for net effect was 3. REGISTRATION: This study was prospectively registered in the PROSPERO database under registration number CRD42021231107.
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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.