SynthesisWorld journal of emergency surgery : WJES2026
Interrupted versus continuous fascial closure after emergency midline laparotomy: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in World journal of emergency surgery : WJES, 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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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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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWound dehiscence after emergency midline laparotomy is a severe complication linked to high morbidity and mortality. While continuous closure is standard in elective surgery, its superiority is not established in high-risk emergency settings, where patient factors like infection and malnutrition can compromise healing. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of interrupted versus continuous fascial closure techniques after emergency midline laparotomy.
methodsA comprehensive search of PubMed, Scopus, CENTRAL, Google Scholar, and Web of Science was conducted for RCTs up to October 2025. The primary outcome was wound dehiscence. Secondary outcomes included wound infection, incisional hernia, and length of hospital stay (LoS). Risk ratios (RR) and mean differences (MD) were pooled using STATA 19.5, with 95% confidence intervals (CI).
resultsTwenty-five RCTs involving 3,548 patients were included. Interrupted closure significantly reduced the risk of wound dehiscence compared to continuous closure (RR: 0.47, 95% CI [0.38, 0.87]; p < 0.001). There was no significant difference in wound infection (RR: 0.91, 95% CI [0.76, 1.09]; p = 0.31) or incisional hernia (RR: 0.83, 95% CI [0.57, 1.22]; p = 0.34). However, interrupted closure was also associated with a significantly shorter LoS (MD: - 3.52 days, 95% CI [- 4.75, - 2.29]; p < 0.001).
conclusionIn the high-risk emergency midline laparotomy setting, current evidence suggests that interrupted fascial closure may be associated with a reduction in wound dehiscence and a shorter LoS compared to continuous closure. However, given the risk of bias and clinical heterogeneity among the included studies, these findings should be interpreted with caution, and further high-quality, standardized trials are warranted.
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