Evidence map›Paper›PMID 41504702›Full record

Trial reportBJS open2025

Reinforced tension-line suture after laparotomy: long-term results of Rein4CeTo1 randomized clinical trial.

Charlotta L Wenzelberg, Peder Rogmark, Olle Ekberg, Ulf Petersson, Carl-Fredrik Rönnow

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BJS open, 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

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

1 citing paper in PubMed.

  1. 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

5 authors.

Charlotta L WenzelbergDepartment of Clinical Sciences Malmö, Lund University, Lund, Sweden.ORCID 0000-0001-8079-1276
Peder RogmarkDepartment of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Olle EkbergDepartment of Translational Medicine Malmö, Lund University, Lund, Sweden.
Ulf PeterssonDepartment of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Carl-Fredrik RönnowDepartment of Clinical Sciences Malmö, Lund University, Lund, Sweden.ORCID 0000-0001-5848-1407

Funding

Einar and Inga Nilsson fundHelge B. Wulff fundsRegion of SkåneSkåne University Hospital
6 · The paper itself

Abstract

backgroundIncisional hernia remains the most common complication of open abdominal surgery. The aim was to investigate whether a reinforced tension-line suture combined with standard 4 : 1 small-bite closure reduces the 3-year incidence of computed tomography-detected incisional hernia in open colorectal cancer surgery.

methodsPatients aged > 18 years, scheduled for colorectal cancer resection through a midline incision between 2017 and 2021 at Skåne University Hospital Malmö and Kristianstad County Hospital, Sweden, were eligible for inclusion. Patients were randomized to fascial closure by reinforced tension-line suture combined with 4 : 1 small-bite closure with polypropylene sutures (RTL group) or 4 : 1 small-bite closure alone with polydioxanone sutures (PDS group), in a 1 : 1 ratio. Computed tomography interpreters were blinded to study groups. Univariate, bivariate, and multivariate logistic regression analyses were performed to investigate and adjust study groups for potential risk factors for incisional hernia.

resultsThe study randomized 80 patients in each group. At 3 years, 101 remained for analysis: 43 in the RTL group and 58 in the PDS group. Incisional hernia was detected in 27 patients: 6 of 43 (14%) in the RTL and 21 of 58 (36%) in the PDS group, resulting in a significant risk difference of 22% (odds ratio 3.50, 95% confidence interval 1.27 to 9.66; P = 0.016). In multivariate analysis, the PDS group (odds ratio 3.40, 1.14 to 10.14; P = 0.028) and adjuvant chemotherapy (odds ratio 2.98, 1.10 to 8.08; P = 0.032) were significant risk factors for incisional hernia. No adverse events related to the closure techniques were found in either group.

conclusionAdding a reinforced tension-line suture significantly reduced the long-term incidence of incisional hernia compared with the 4 : 1 small-bite technique alone in patients undergoing open colorectal cancer surgery. These findings suggest that the reinforced tension-line suture is an efficient and easy way to prevent incisional hernia.

Indexed as

Colorectal NeoplasmsIncisional HerniaLaparotomySuturesSuture TechniquesAbdominal Wound Closure TechniquesAgedFemaleHumansIncidenceMaleMiddle AgedPolydioxanonePolypropylenesRisk FactorsSwedenPolydioxanonePolypropylenes

Identifiers

PMID41504702
PMCPMC12781198

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.