SynthesisANZ journal of surgery2026
Comparative Outcomes of Reinforced Tension-Line Sutures Versus Standard Closure Techniques in Patients Undergoing Laparotomy: A Systematic Review and Meta-Analysis.
Synthesis in ANZ journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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7 authors.
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Abstract
backgroundThe reinforced tension-line suture (RTLS) technique distributes mechanical stress more evenly than traditional closure when closing a laparotomy wound, potentially reducing incisional hernia (IH) risk. We aimed to compare outcomes of RTLS versus standard closure techniques in patients undergoing laparotomy.
methodsSystematic search of PubMed, MEDLINE, Web of Science, and bibliographic reference lists was conducted (last search: 26 January 2025). The protocol was registered with PROSPERO. Comparative studies reporting outcomes of RTLS versus other closure methods were included and their risk of bias was assessed. IH, Clavien-Dindo (C-D) ≥ III complications, wound dehiscence, wound infection, and procedure time were the evaluated outcome measures. Odds ratios (OR) for dichotomous outcomes and mean differences (MD) for continuous variables were determined. Heterogeneity was assessed using I
resultsFive comparative studies (four randomised and one observational) enrolling 708 patients who had their laparotomy wound closed using RTLS (n = 393) or standard closure (n = 315) were included. Use of RTLS significantly reduced risk of IH compared to standard technique (5.6% vs. 18.1%, OR 0.24; 95% CI: 0.15-0.38; p = 0.005). However, no significant differences were found in C-D ≥ III complications (10.2% vs. 3.2%, OR 0.81; 95% CI: 0.18-3.54, p = 0.62), wound dehiscence (2.3% vs. 6.9%, OR 0.34; 95% CI: 0.06-1.84, p = 0.62), wound infection (9.0% and 10.4%, OR 0.34; 95% CI: 0.06-1.84, p = 0.62) or procedure time (MD 23.50; 95% CI: -59.88-106.87, p = 0.16) between two groups.
conclusionsRTLS seems to significantly reduce IH incidence after laparotomy without increasing post-operative morbidities or procedure time. Further Level 1 evidence is needed.
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