Evidence map›Paper›PMID 40419575›Full record

ArticleScientific reports2025

A virtual simulation study of the effects of laparotomy incision location and wound stiffness on abdominal wall mechanics.

Lluís Tuset, Manuel López-Cano, Gerard Fortuny, Josep M López, Joan Herrero, Dolors Puigjaner

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Analysis of morphological patterns in incisional hernias following different surgical approaches.Hernia : the journal of hernias and abdominal wall surgery · 2026
    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

6 authors.

Lluís TusetDepartament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalonia, Spain.
Manuel López-CanoAbdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Gerard FortunyDepartament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalonia, Spain.
Josep M LópezDepartament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalonia, Spain.
Joan HerreroDepartament d'Enginyeria Química, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalonia, Spain.
Dolors PuigjanerDepartament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av Països Catalans 26, Tarragona, Catalonia, Spain. dolors.puigjaner@urv.cat.

Funding

Agència de Gestió d'Ajuts Universitaris i de Recerca 2021SGR-00111: ASCLEPIUS: Smart Technology for Smart Healthcare
6 · The paper itself

Abstract

Incisional hernia (IH) is a common complication of laparotomy surgical procedures, influenced by factors such as incision location and surgical wound (SW) tissue strength, and the intra-abdominal pressure (IAP) levels the patient is subject to. In this study we use finite element simulations to investigate how these factors affect the abdominal wall (AW) deformation and the stress distribution on the tissues. Comprehensive geometric models of the AW were generated for five laparotomy incisions, namely midline, paramedian, pararectus, transverse supraumbilical, and subcostal oblique. Finite element simulations for IAP values between 4 and 20 kPa and with the SW tissue strength ranging from very soft to very stiff were conducted using the code Aster open-source software. Simulations revealed that as a general rule laparotomy incisions significantly impact AW mechanics when the SW tissue is soft. In particular, AW mechanics is more sensitive to SW strength in vertical incisions (midline, paramedian, pararectus). The resulting change of the SW dimensions with increasing IAP was also investigated. Softening the SW tissue led to substantial volume increases of the vertical incisions for a given IAP level. In addition, we analyzed stress levels in the SW tissue as well as in the surrounding muscles. A very soft SW may induce the appearance of regions with very high stress levels in the surrounding muscle tissue, heightening their rupture risk. This effect was especially noticeable for the midline incision. On the overall, we found that when the SW tissue is too tender transverse supraumbilical and subcostal incisions present the lowest risk of tissue ruptures whereas the midline incision is the most vulnerable one and the paramedian and pararectus incisions stand midway. In summary, the results of the present simulation provide full support for the clinical guidelines' recommendation to avoid midline incisions in abdominal surgeries whenever possible.

Indexed as

Abdominal WallIncisional HerniaLaparotomySurgical WoundBiomechanical PhenomenaComputer SimulationFinite Element AnalysisHumansStress, MechanicalAbdominal wallFinite element methodIncisionLaparotomyOpen-source softwareOpen surgery

Identifiers

PMID40419575
PMCPMC12106805

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LicenceCC BY-NC-ND
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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.