Evidence map›Paper›PMID 42154339›Full record

SynthesisHernia : the journal of hernias and abdominal wall surgery2026

Impact of the SUture BIte TEchnique on clinical outcomes after midline laparotomy closure: SUBITE-a systematic review and meta-analysis.

Markus Golling, Petra Baumann, Fabian Kuger, René H Fortelny

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis 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.

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

4 authors.

Markus GollingDIAK Hospital, County Hospital Schwaebisch Hall, Department of General & Visceral Surgery, Diakoniestrasse 10, Schwaebisch Hall, 75432, Germany.ORCID http://orcid.org/0000-0001-8844-4922
Petra BaumannDepartment of Medical Scientific Affairs, Aesculap AG, Tuttlingen, Am Aesculap Platz, 78532, Germany.
Fabian KugerDepartment of Medical Scientific Affairs, Aesculap AG, Tuttlingen, Am Aesculap Platz, 78532, Germany.
René H FortelnySigmund Freud Private University Vienna: Sigmund Freud PrivatUniversitat Wien, Vienna, Austria. dr.fortelny@gmail.com.ORCID http://orcid.org/0000-0002-0066-7716

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective of this Systematic Review and Meta-Analysis (SR/MA) was to identify the best suture technique (short or large bites) for abdominal wall closure with respect to relevant outcome parameters such as incisional hernia (IH), surgical site infection (SSI) and linea alba (aponeurotic layer of the abdominal wall) dehiscence (LAD).

methodsRegistration was done in PROSPERO, a systematic literature search was performed in three data bases (PubMed, Embase and Cochrane). Randomised controlled (RCT) as well as non-randomised controlled trials (n-RCT) comparing the short (SB) versus large bite (LB) technique for abdominal wall closure after midline laparotomy were eligible for inclusion. Quality assessment was performed for RCTs (ROB) & n-RCTs (ROBINS-1, MINORS). The incidence of IH, SSI, LAD as well as the length of hospital stay (LOS) and time to close the linea alba (aponeurotic layer of the abdominal wall) were analysed as outcome parameters. Odds ratio with 95% confidence intervals were chosen to determine statistical significance. Heterogeneity was explored using the I

resultsThis SR/MA comprised in total 5886 patients (large bite group 3339 vs. 2547 short bite group) enrolled in 7 RCTs and 5 n-RCTs. The SB-technique was associated with a significant lower IH, SSI, FD rate and a shorter LOS compared to the LB-technique (IH: Odds Ratio OR = 0.47 (95% CI 0.38-0.58; p < 0.00001; I

conclusionThis systematic review and meta-analysis demonstrate consistent reductions in incisional hernia and surgical site infection with the small bites technique for midline laparotomy closure. The direction of effect is stable across randomized and comparative studies and supported by available long-term data. The clinical relevance and consistency of these findings support preferential use of the small bites technique in routine practice. The present evidence provides a robust basis for consideration in future updates of EHS abdominal wall closure guidelines. REGISTRATION: PROSPERO, registration number: CRD420251033244, registration date: 16th April 2025.

Indexed as

Abdominal Wound Closure TechniquesLaparotomySuture TechniquesAbdominal WallHumansIncisional HerniaLength of StaySurgical Wound DehiscenceSurgical Wound InfectionAbdominal wall closureFascial dehiscenceIncisional herniaLarge bitesMeta-analysisMidline laparotomySmall bitesSurgical site infectionsSuture techniqueSystematic review

Identifiers

PMID42154339
PMCPMC13186860

What OpenQuestion holds

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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.