Small Bites vs Large Bites for Closure of Abdominal Midline Incisions

Does small-bites fascial closure reduce the long-term incidence and severity of incisional hernias compared with large-bites closure after elective midline laparotomy?In this multicenter randomized trial with median follow-up of 8 years (maximum 15 years), cumulative incidence of incisional hernia at 13 years was 34% in the small-bites group vs 49% in the large-bites group. Hernias in the small-bites group were smaller and quality of life was lower in patients with an incisional hernia.Small-bites fascial closure significantly reduced long-term incidence and size of incisional hernia and should be considered standard practice.

Corresponding Author: Eva B. Deerenberg, MD, PhD, Department of General Surgery, Franciscus Gasthuis e.deerenberg@franciscus.nl).

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