Effects of the short stitch technique for midline abdominal closure on incisional hernia (ESTOIH): randomized clinical trial

Abstract Background Incisional hernia remains a frequent problem after midline laparotomy. This study compared a short stitch to standard loop closure using an ultra-long-term absorbent elastic suture material. Methods A prospective, multicentre, parallel-group, double-blind, randomized, controlled...

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Veröffentlicht in:British journal of surgery 2022-08, Vol.109 (9), p.839-845
Hauptverfasser: Fortelny, René H, Andrade, Dorian, Schirren, Malte, Baumann, Petra, Riedl, Stefan, Reisensohn, Claudia, Kewer, Jan Ludolf, Hoelderle, Jessica, Shamiyeh, Andreas, Klugsberger, Bettina, Maier, Theo David, Schumacher, Guido, Köckerling, Ferdinand, Pession, Ursula, Hofmann, Anna, Albertsmeier, Markus
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Sprache:eng
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Zusammenfassung:Abstract Background Incisional hernia remains a frequent problem after midline laparotomy. This study compared a short stitch to standard loop closure using an ultra-long-term absorbent elastic suture material. Methods A prospective, multicentre, parallel-group, double-blind, randomized, controlled superiority trial was designed for the elective setting. Adult patients were randomly assigned by computer-generated sequence to fascial closure using a short stitch (5 to 8 mm every 5 mm, USP 2-0, single thread HR 26 mm needle) or long stitch technique (10 mm every 10 mm, USP 1, double loop, HR 48 mm needle) with a poly-4-hydroxybutyrate-based suture material (Monomax®). Incisional hernia assessed by ultrasound 1 year after surgery was the primary outcome. Results The trial randomized 425 patients to short (n = 215) or long stitch technique (n = 210) of whom 414 (97.4 per cent) completed 1 year of follow-up. In the short stitch group, the fascia was closed with more stitches (46 (12 s.d.) versus 25 (7 s.d.); P 
ISSN:0007-1323
1365-2168
DOI:10.1093/bjs/znac194