Effect of Small Stitches on Incisional Hernia After Surgery
Author Information
Author(s): Harlaar Joris J, Deerenberg Eva B, van Ramshorst Gabrielle H, Lont Harold E, van der Borst Ed CMH, Schouten Willem R, Heisterkamp Joos, van Doorn Helena C, Cense Huib A, Berends Frits, Stockmann Hein B, Vrijland Wietske W, Consten Esther CJ, Ottow Reyer T, Go Peter MNYH, Hermans John J, Steyerberg Ewout W, Lange Johan F
Primary Institution: Erasmus University Medical Center
Hypothesis
The small bites technique will result in a significant reduction of the incidence of incisional hernia compared to the large bites technique.
Conclusion
The STITCH trial will provide evidence to support the preference for either a continuous suture technique with many small tissue bites or for the commonly used large bites technique.
Supporting Evidence
- Small stitches placed 4-6 mm from the wound edge only cut through the aponeurosis, leading to stronger wounds.
- Experimental data showed a 47% increase in breaking strength when small bites were used compared to the routine technique.
- A randomized clinical study reported a decrease in the incidence of incisional hernia from 18% to 5.6% with small bites.
Takeaway
This study is trying to find out if using smaller stitches during surgery can help prevent hernias, which are bulges that can happen after surgery.
Methodology
The study is a double-blinded multicenter randomized controlled trial comparing small bites and large bites suture techniques.
Potential Biases
Potential bias due to the inability to blind surgeons during the procedure.
Limitations
The study may face challenges in standardizing techniques across multiple centers with different surgeons.
Participant Demographics
Patients scheduled for elective abdominal operations through a midline incision, aged 18 years or older.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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