What question did this study set out to answer?

The study aims to evaluate the incidence of incisional hernias 13 years after midline laparotomy using different closure techniques.

April 3, 2026JAMA Surgery

Small Bites vs Large Bites for Closure of Abdominal Midline Incisions

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Authors

RBR. van den Berg SESarah van Egmond FSFokko Smits

Discussion

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Overview

Multicenter randomized trial evaluates incisional hernia incidence after different closure techniques in abdominal surgery, highlighting long-term benefit of small bites.

Key Points

The study aims to evaluate the incidence of incisional hernias 13 years after midline laparotomy using different closure techniques.
Multicenter, double-blind randomized trial design done between October 2009 and March 2012.
559 patients undergoing elective midline laparotomy were randomized to small-bites or large-bites closure.
Primary outcome was cumulative incidence of incisional hernia analyzed with time-to-event methods.
At 13 years, incisional hernia cumulative incidence was 34% in the small-bites group and 49% in the large-bites group.
Hernia widths greater than 20 mm were 17% for small-bites and 34% for large-bites (hazard ratio 0.36).
Smaller hernia sizes were observed in the small-bites group at final follow-up (mean 25 mm vs 43 mm; P = .02).

Cite This Study

Berg et al. (2026) studied this question.

synapsesocial.com/papers/69cf5f005a333a821460dd42 https://doi.org/10.1001/jamasurg.2026.0618

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April 3, 2026JAMA Surgery

Small Bites vs Large Bites for Closure of Abdominal Midline Incisions

View Full Paper

Ask AI

Bookmark

Authors

RBR. van den Berg SESarah van Egmond FSFokko Smits

Discussion

Member takes

Overview

Multicenter randomized trial evaluates incisional hernia incidence after different closure techniques in abdominal surgery, highlighting long-term benefit of small bites.

Key Points

The study aims to evaluate the incidence of incisional hernias 13 years after midline laparotomy using different closure techniques.
Multicenter, double-blind randomized trial design done between October 2009 and March 2012.
559 patients undergoing elective midline laparotomy were randomized to small-bites or large-bites closure.
Primary outcome was cumulative incidence of incisional hernia analyzed with time-to-event methods.
At 13 years, incisional hernia cumulative incidence was 34% in the small-bites group and 49% in the large-bites group.
Hernia widths greater than 20 mm were 17% for small-bites and 34% for large-bites (hazard ratio 0.36).
Smaller hernia sizes were observed in the small-bites group at final follow-up (mean 25 mm vs 43 mm; P = .02).

Cite This Study

Berg et al. (2026) studied this question.

synapsesocial.com/papers/69cf5f005a333a821460dd42 https://doi.org/10.1001/jamasurg.2026.0618

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