Meta-analysis finds small-bite closure cuts incisional hernia risk after laparotomy

This meta-analysis of 10 RCTs (2617 patients) compared small-bite (5-mm) versus large-bite (10-mm) fascial closure techniques following midline laparotomy. The authors report that small-bite closure reduced incisional hernia risk by 43-69% depending on assessment method, with benefit persisting beyond 2 years of follow-up, and was also associated with reduced surgical-site infection and total complications, though closure time was slightly longer with no differences in seroma, fascial dehiscence, or pain scores.

Most relevant for: Patients undergoing midline laparotomy and surgeons performing fascial closure after abdominal surgery.

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