Evidence map›Paper›PMID 41163187›Full record

ArticleTrials2025

A modern comparison of suture repair versus mesh repair for incisional hernia: a study protocol for a randomized controlled trial.

Sara M Maskal, Benjamin T Miller, Ryan C Ellis, Lucas R A Beffa, Ajita S Prabhu, Michael J Rosen, David M Krpata, Li-Ching Huang, Clayton C Petro

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05599750 (A Modern Comparison of Suture Repair With Mesh Repair for Incisional Hernia), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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.

NCT05599750 narecruitingnot on this map

A Modern Comparison of Suture Repair With Mesh Repair for Incisional Hernia

TypeinterventionalSponsorClayton PetroRan2022 to 2031Enrolled154ConditionsIncisional HerniaArmsIncisional hernia repair
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. 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

9 authors.

Sara M MaskalDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. maskals2@ccf.org.
Benjamin T MillerDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Ryan C EllisDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Lucas R A BeffaDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Ajita S PrabhuDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Michael J RosenDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
David M KrpataDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Li-Ching HuangDepartment of Biostatistics, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1100, Nashville, TN, 37203-1741, USA.
Clayton C PetroDepartment of Surgery, Cleveland Clinic Center for Abdominal Core Health, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe utilization of mesh is considered the standard of care for incisional hernia repairs to reduce recurrence. However, mesh complications-including infection and enterocutaneous fistulae-can impact patients' quality of life and culminate in reoperation. Meanwhile, techniques for fascial closure and our understanding of abdominal wall tension physiology have improved since the original studies comparing suture and mesh-based ventral hernia repairs were published, but there have been no contemporary trials comparing these approaches since the evolution of fascial closure techniques.

methodsThis is a registry-based, multicenter, patient-blinded randomized controlled trial designed to investigate whether a suture-only technique utilizing a posterior rectus sheath release, small bite technique, and 4:1 closure is non-inferior to a retrorectus mesh-based repair for clean, incisional hernias that are 2-6 cm in width. The primary study endpoint is abdominal wall-specific quality of life (HerQLes) at one year postoperatively. Our primary hypothesis is that suture-based incisional hernia repair will be non-inferior to mesh-based repairs with respect to HerQLes summary score at one year postoperatively. Secondary outcomes of interest include hernia recurrence at 1, 2, and 5 years postoperatively, pain as measured by the PROMIS-3a Pain Intensity survey, cost-effectiveness ratios, 30-day readmissions, wound complications, and reoperations. Additional outcomes include hernia recurrence, patient-reported quality of life, wound complications, and hernia-related reoperation at 30 days, 1 year, 2 years, and 5 years. DISCUSSION: The risks of mesh-related complications, coupled with the lack of contemporary data, warrant new investigation into the necessity of mesh placement for all incisional hernias.

trial registrationClinicaltrials.gov NCT05599750. Registered on October 26, 2022.

Indexed as

HerniorrhaphyIncisional HerniaSurgical MeshSuture TechniquesHumansMulticenter Studies as TopicQuality of LifeRandomized Controlled Trials as TopicRecurrenceRegistriesTime FactorsTreatment OutcomeHernia meshIncisional hernia repairPosterior rectus sheath incisionSmall bite techniqueSuture-only repairVentral hernia

Identifiers

PMID41163187
PMCPMC12574033

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.