title: [Do we need to relearn abdominal wall closure? : Small stitches].
abstract: The 1‑year incisional hernia rate of 9-30 % has been tolerated for decades. Even in the 1970s and 1980s there was evidence that supported reducing suture tension. Recently, the traditional 4:1 relationship between suture and wound length, which has been passed on for years, has been questioned. After first experimental and clinical data suggested an advantage by reducing the width and interval of stitches by 50 %, the prospective randomized STITCH study has now provided evidence by significantly lowering the 1‑year hernia rate from 21 % to 13 %. For surgeons this means less of a revolution and more of an innovative evolution of a long-established technique. Before introduction of the technique quality assurance must be carried out with documentation of performance indicators (e.g. number of stitches, length of thread incorporated and wound length).
authors: Klinik für Allgemein- und Viszeralchirurgie, Das DIAK, Diakonieklinikum Schwäbisch Hall, Diakoniestr. 10, 74523, Schwäbisch Hall, Deutschland. markus.golling@dasdiak.de.
authors: M
authors: M
authors: Golling
authors: Klinik für Allgemein- und Viszeralchirurgie, Das DIAK, Diakonieklinikum Schwäbisch Hall, Diakoniestr. 10, 74523, Schwäbisch Hall, Deutschland.
authors: S
authors: S
authors: Felbinger
authors: Klinik für Allgemein- und Viszeralchirurgie, Das DIAK, Diakonieklinikum Schwäbisch Hall, Diakoniestr. 10, 74523, Schwäbisch Hall, Deutschland.
authors: Z
authors: Z
authors: Zielska
authors: Aesculap AG, Tuttlingen, Deutschland.
authors: K
authors: K
authors: Maurer
authors: Aesculap AG, Tuttlingen, Deutschland.
authors: P
authors: P
authors: Baumann
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000193:education* / Q000592:standards; D004502:Education, Medical, Continuing; D006801:Humans; D000069290:Incisional Hernia / Q000517:prevention & control; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000592:standards; D016032:Randomized Controlled Trials as Topic; D040521:Subcutaneous Tissue / Q000601:surgery; D013536:Suture Techniques / Q000193:education
keywords: Fascial closure; Incisional hernia; Prophylaxis; Short stitch; Suture technique