ArticleHernia : the journal of hernias and abdominal wall surgery2026
Incisional hernia after continuous barbed versus interrupted non-barbed sutures for midline fascial closure in minimally invasive colorectal cancer surgery: a propensity score-matched analysis.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Barbed Sutures Are Associated With a Lower Incidence of Incisional Hernia Compared With Continuous Non-Barbed Monofilament Sutures After Minimally Invasive Gastroenterological Surgery.Annals of gastroenterological surgery · 2026Article
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7 authors.
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Abstract
purposeIncisional hernia (IH) is a common complication of abdominal surgery, and the optimal suture technique for midline fascial closure remains controversial. This study compared continuous barbed sutures with interrupted non-barbed sutures in patients who underwent minimally invasive colorectal cancer surgery.
methodsWe retrospectively evaluated 299 patients who underwent laparoscopic or robotic radical colorectal resection between 2020 and 2023. Of these, 228 who underwent a small midline umbilical incision were included. Fascial closure was performed using either continuous barbed absorbable sutures (n = 60) or interrupted non-barbed absorbable sutures (n = 162). Propensity score matching (PSM) was performed at a 1:1 ratio, yielding 51 matched pairs for comparison. Primary outcome was IH incidence as confirmed by computed tomography or physical examination. Secondary outcomes focused on infectious complications as well as postoperative morbidity, mortality, and hospital stay.
resultsAfter PSM, the incidence of IH was significantly lower in the continuous barbed group than that in the interrupted non-barbed group (7.8% vs. 33.3%, P = 0.001). In non-obese patients (Body mass index < 25), barbed closure reduced the IH incidence (2.7% vs. 23.5%, P = 0.006). In obese patients, the difference was not statistically significant (21.4% vs. 52.9%, P = 0.07), likely reflecting limited power. Although ileus was more frequent in the interrupted non-barbed group (7.8% vs. 0%, P = 0.02), infectious complications were comparable between groups. Multivariable analysis identified interrupted non-barbed sutures and obesity as independent risk factors for IH.
conclusionsContinuous barbed fascial closure was associated with a significantly lower IH incidence after minimally invasive colorectal cancer surgery without increasing infectious complications. These findings support the effectiveness of a barbed-continuous closure strategy for midline extraction incisions.
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