This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
Edgard Efren Lozada Hernández
Department of Surgery and Clinical Research, Hospital Regional de Alta Especialidad del Bajío.
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Incisional hernia (IH) is the main complication after laparotomy. The objective of this meta-analysis was to evaluate the effectiveness of closure technique modification (CTM) for reducing the incidence of IH to provide objective support for its recommendation.
Methods: A meta-analysis was performed according to the PRISMA guidelines. The primary objective was to determine the incidence of IH, and the secondary objective was to determine the incidence of acute evisceration and postoperative complications. Only published clinical trials were included. The risk of bias was analyzed, and the random effects model was used to determine statistical significance.
Results: Nine studies comparing 2,612 patients were inclued. The incidence of IH was significantly lower in the CTM group than in the control group, with an OR of 0.39 (95% CI 0.26-0.57). The incidence of acute postoperative evisceration was also reduced, with an OR of 0.46 (95% CI 0.23-0.92). Associated complications, including hematoma, seroma, and postoperative pain, could not be analyzed; however, CTM did not increase the risk of surgical site infection.
Conclusion: CTM for midline laparotomy significantly reduces the incidence of IH compared to conventional closure. Limitations of the analysis included differences in follow-up, patient selection, diagnostic methods, and the reporting of postoperative complications among the studies.
Funding Information: No funding was received.
Registration: This study was prospectively registered in the PROSPERO database under registration number CRD42021231107.
Keywords
Reinforced tension line, Small bites, Prevention of incisional hernia, Closure technique modification
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No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Edgard Efren Lozada Hernández
Department of Surgery and Clinical Research, Hospital Regional de Alta Especialidad del Bajío.
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 17 Nov, 2021
No community comments so far
Reviewers invited
Invitations sent on 14 Nov, 2021
Editor assigned
On 14 Nov, 2021
Editor invited
On 11 Nov, 2021
Submission checks complete
On 11 Nov, 2021
First submitted
On 29 Oct, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Incisional hernia (IH) is the main complication after laparotomy. The objective of this meta-analysis was to evaluate the effectiveness of closure technique modification (CTM) for reducing the incidence of IH to provide objective support for its recommendation.
Methods: A meta-analysis was performed according to the PRISMA guidelines. The primary objective was to determine the incidence of IH, and the secondary objective was to determine the incidence of acute evisceration and postoperative complications. Only published clinical trials were included. The risk of bias was analyzed, and the random effects model was used to determine statistical significance.
Results: Nine studies comparing 2,612 patients were inclued. The incidence of IH was significantly lower in the CTM group than in the control group, with an OR of 0.39 (95% CI 0.26-0.57). The incidence of acute postoperative evisceration was also reduced, with an OR of 0.46 (95% CI 0.23-0.92). Associated complications, including hematoma, seroma, and postoperative pain, could not be analyzed; however, CTM did not increase the risk of surgical site infection.
Conclusion: CTM for midline laparotomy significantly reduces the incidence of IH compared to conventional closure. Limitations of the analysis included differences in follow-up, patient selection, diagnostic methods, and the reporting of postoperative complications among the studies.
Funding Information: No funding was received.
Registration: This study was prospectively registered in the PROSPERO database under registration number CRD42021231107.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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