Small Bites vs Large Bites for Closure of Abdominal Midline Incisions: A Randomized Clinical Trial - PubMed
6 hours ago
- #Long-term Outcomes
- #Incisional Hernia
- #Surgical Technique
- The small-bites fascial closure technique (5 mm × 5 mm) reduces long-term incisional hernia risk compared to large bites (10 mm × 10 mm) after elective midline laparotomy.
- At 13-year follow-up, cumulative incisional hernia incidence was 34% for small bites vs. 49% for large bites (HR 0.61, 95% CI 0.43–0.86).
- Hernias in the small-bites group were significantly smaller (mean width 25 mm vs. 43 mm) and less likely to exceed 20 mm (17% vs. 34%; HR 0.36, 95% CI 0.21–0.60).
- Hernia repair rates were similar between groups, but patients with hernias reported significantly lower quality of life.
- The study recommends small-bites closure as standard practice due to its simplicity, cost neutrality, and broad applicability.