Related Experiment Video
Updated: Jul 27, 2025
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Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications
Published on: May 10, 2024
819
Low incisional hernia incidence using a large-bite, low-tension technique for celiotomy closure
Joy Sarkar1, Michael J Minarich2, Levi Y Smucker2
1Roswell Park Cancer Institute, Department of Surgical Oncology, Buffalo, NY, USA.
Surgery Open Science
|June 5, 2023
Summary
This study demonstrates a continuous closure technique significantly reduces incisional hernia rates after abdominal surgery. The method achieved a 3.3% overall hernia rate, outperforming previous techniques and offering a safer approach for patients.
Area of Science:
- Surgical Innovation
- Abdominal Surgery
- Hernia Repair
Background:
- Incisional hernias (IH) affect 5-20% of patients after open celiotomy.
- Closure technique is a key factor influencing IH development.
- The STITCH trial showed smaller bites reduced IH rates compared to larger bites.
Purpose of the Study:
- To evaluate the efficacy of a continuous musculofascial mass closure technique.
- To determine the incisional hernia rate associated with this specific closure method.
- To identify clinicopathologic factors linked to incisional hernia formation.
Main Methods:
- A continuous closure technique using #1 PDS suture was applied to 336 open celiotomies.
- Data on IH frequency and patient factors were retrospectively analyzed.
- The study involved patients undergoing various visceral resections by a single surgeon.
Main Results:
- The overall IH rate was 3.3% at a median follow-up of 19.5 months.
- Hernia rates were 2.5% for subcostal, 2.9% for midline, and 5.5% for other incisions.
- Increased weight, abdominal depth/girth, male sex, spleen size, visceral fat, and body height were associated with IH.
Conclusions:
- The continuous closure technique results in low IH rates (<3%) for subcostal and midline incisions.
- This technique is recommended for routine use in open celiotomy.
- Observed results suggest superiority over the STITCH trial's findings.
