{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:37:13Z","timestamp":1779197833103,"version":"3.51.4"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>To analyze laparotomy closure quality (suture\/wound length ratio; SL\/WL) and short term complications (surgical site occurrence; SSO) of conventional midline and transverse abdominal incisions in elective and emergency laparotomies with a longterm, absorbent, elastic suture material.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>Prospective, monocentric, non-randomized, controlled cohort study on short stitches with a longterm resorbable, elastic suture (poly-4-hydroxybutyrate, [p-4OHB]) aiming at a 6:1 SL\/WL-ratio in midline and transverse, primary and secondary laparotomies for elective and emergency surgeries.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 351 patients (\u2642: 208; \u2640: 143) with midline (<jats:italic>n<\/jats:italic>\u2009=\u2009194), transverse (<jats:italic>n<\/jats:italic>\u2009=\u2009103), and a combined midline\/transverse L-shaped (<jats:italic>n<\/jats:italic>\u2009=\u200954) incisions. There was no quality difference in short stitches between elective (<jats:italic>n<\/jats:italic>\u2009=\u2009296) and emergency (<jats:italic>n<\/jats:italic>\u2009=\u200955) operations. Average SL\/WL-ratio was significantly higher for midline than transverse incisions (6.62\u2009\u00b1\u20092.5 vs 4.3\u2009\u00b1\u20091.51, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Results in the first 150 patients showed a reduced SL\/WL-ratio to the following 200 suture closures (SL\/WL-ratio: 5.64\u2009\u00b1\u20092.5 vs 6.1\u2009\u00b1\u20092.3; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). SL\/WL-ratio varied insignificantly among the six surgeons participating while results were steadily improving over time.<\/jats:p>\n                <jats:p>Clinically, superficial surgical site infections (SSI, CDC-A1\/2) were encountered in 8%, while 4,3% were related to intraabdominal complications (CDC-A3). An abdominal wall dehiscence (AWD) occurred in 22\/351 patients (6,3%)\u2014twice as common in emergency than elective surgery (12,7 vs 5,1%)\u2014necessitating an abdominal revision in 86,3% of cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We could show that a short stitch 6:1 SL\/WL-ratio with a 2\u20130 single, ultra-long term, absorbent, elastic suture material can be performed in only 43% of cases (85%\u2009&gt;\u20094:1 SL\/WL-ratio), significantly better in midline than transverse incisions. Transverse incisions should preferably be closed in two layers to achieve a sufficient SL\/WL-ratio equivalent to the median incision.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical Trials.gov Identifier<\/jats:title>\n                <jats:p>NCT01938222.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10029-023-02927-4","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T13:04:04Z","timestamp":1706533444000},"page":"447-456","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The 6:1 short stitch SL-WL-ratio: short term closure results of transverse and midline incisions in elective and emergency operations"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8844-4922","authenticated-orcid":false,"given":"M.","family":"Golling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Breul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.","family":"Zielska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2927_CR1","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.ijsu.2019.09.024","volume":"71","author":"A Bloemen","year":"2019","unstructured":"Bloemen A, De Kleijn RJCdMF, van Steensel S et al (2019) Laparotomy closure techniques: Do surgeons follow the latest guidelines? 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We used the regular fascial suture material provided by the hospital (MonoMax 2\u20130\u00ae), produced by BBraun. Technical results described in the publication are not ment to refer to a specific suture material but rather the technique used.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval has been approved by Heidelberg Universtiy.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"No animal of human subjects were used for this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"This work did not require informed consent of any subjects.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}