Evidence map›Paper›PMID 40299231›Full record

SynthesisUpdates in surgery2025

Modified Smead-Jones suture for closure of emergency midline laparotomy incision: systematic review and meta-analysis.

Mahmoud Diaa Hindawi, Ruaa Mustafa Qafesha, Ahmed Hamdy G Ali, Hazim Alkousheh, Hatem Eldeeb, Haitham Salem, Abd-Elfattah Kalmoush, Amr Elrosasy

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
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

8 authors.

Mahmoud Diaa HindawiFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID http://orcid.org/0009-0001-3085-6665
Ruaa Mustafa QafeshaFaculty of Medicine, Al-Quds University, Jerusalem, Palestine.ORCID http://orcid.org/0000-0002-8745-0260
Ahmed Hamdy G AliFaculty of Medicine, Ogarev Mordovia State University, Saransk, Russia.ORCID http://orcid.org/0009-0000-2706-5275
Hazim AlkoushehFaculty of Medicine, Hashemite University, Zarqa, Jordan.ORCID http://orcid.org/0009-0003-7175-7529
Hatem EldeebFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-6270-3180
Haitham SalemFaculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID http://orcid.org/0009-0000-7686-9288
Abd-Elfattah KalmoushGeneral Surgery Department, Al-Azhar University, Cairo, Egypt.ORCID http://orcid.org/0000-0001-6927-223X
Amr ElrosasyFaculty of Medicine, Cairo University, Cairo, Egypt. 10912022103193@stud.cu.edu.eg.ORCID http://orcid.org/0000-0002-5592-3908

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Midline laparotomy incision is mostly used in emergent surgery, especially in hemodynamic instability patients. We aim to compare the Modified Smead-Jones (MSJ) and Smead-Jones (SJ) sutures against conventional continuous suture in midline laparotomy closure. PubMed, Scopus, Web of Science, and Ovoid were searched. We utilized Revman 5.4.1 for statistical analysis. Five studies involving 403 patients were included. Compared to continuous sutures, MSJ showed a significant reduction in wound dehiscence, wound infection, and hospital stay (RR = 0.29, 95% CI [0.14-0.59], p = 0.0006), (RR = 0.41, 95% CI [0.26-0.65], p = 0.0002), and (MD = - 4.50, 95% CI [- 5.43 to - 3.57], p = 0.00001). Conversely, the SJ subgroup showed no statistically significant difference in wound dehiscence, wound infection, and hospital stay. Also, both techniques, MSJ and SJ, showed no significant difference in incisional hernia risk (RR = 0.17, 95% CI [0.02-1.33], p = 0.09) and (RR = 5.16, 95% CI [0. 26-103.27], p = 0.28), respectively. MSJ follows the same far-near-near-far pattern as SJ but is applied continuously rather than interrupted. The MSJ suture technique might be promising in reducing wound dehiscence, infection, and hospital stay compared to conventional continuous closure. However, future large-scale RCTs with standardized methodologies and extended follow-up are essential to determine whether MSJ should be established as the preferred technique for midline laparotomy closure.

Indexed as

Abdominal Wound Closure TechniquesLaparotomySuturesSuture TechniquesEmergenciesHumansLength of StaySurgical Wound DehiscenceSurgical Wound InfectionFar-near-near-farIncisional herniaLaparotomyModified Smead JonesWound dehiscence

Identifiers

PMID40299231
PMCPMC12630183

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Registered trials

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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.