Closing a midline laparotomy with small, closely spaced fascial bites prevents more incisional hernias than the traditional large-bite technique, and the benefit lasts beyond two years.
- Small bites cut incisional hernias by 43% in trials that checked with both examination and imaging.
- Ten RCTs with 2,617 patients compared 5-mm bites and spacing with 10-mm bites and spacing.
The cost is about five extra minutes of closure time, with no more pain.
- Small-bite closure also led to fewer surgical site infections and fewer complications overall.
Comparative Study by Emile SH, Elhadad A and Elsayed AH in Br J Surg
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