{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:50:52Z","timestamp":1791935452325,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Incisional herniation (IH) is a frequent complication following midline abdominal closure with significant associated morbidity. Randomized controlled trials have demonstrated that the small bites technique (SBT) and prophylactic mesh augmentation (PMA) may reduce IH compared to mass closure techniques, but data are lacking on their implementation in contemporary surgical practice. This survey aimed to evaluate the use of the SBT and PMA and to identify factors associated with their adoption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Between 22 January 2023 and 16 March 2023, consultant surgeons across the UK were asked to complete a 25\u2010question survey on closure of an elective primary midline incision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses were received from 267 of 675 eligible surgeons (39.6%) in 38 NHS Trusts. Respondents were evenly split between tertiary centres (47.6%) and district general hospitals (49.4%). SBT and PMA were used by 19.9% and 3.0% of respondents, respectively. Compared to other techniques, surgeons using the SBT were more likely to close the anterior aponeurotic layer only, use single suture filaments, 2\u20130 gauge sutures and sharp needle points and routinely dissect abdominal layers to aid closure (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Attendance at lectures\/conferences on SBT (<jats:italic>p<\/jats:italic>\u2009=\u20090.043) and basing practice on available evidence (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were independently associated with use of the SBT. The commonest barriers to adopting SBT were a perceived lack of evidence (23.8%) and belief that personal IH rates were low (16.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A minority of UK consultant surgeons have adopted the SBT or PMA. Practice change should be driven by more widespread dissemination of current evidence and procedural information.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17081","type":"journal-article","created":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T04:40:40Z","timestamp":1719549640000},"page":"1617-1631","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["<scp>CLosure<\/scp> of Abdominal <scp>MidlineS<\/scp> Survey (<scp>CLAMSS<\/scp>): A national survey investigating current practice in the closure of abdominal midline incisions in <scp>UK<\/scp> surgical practice"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9880-2073","authenticated-orcid":false,"given":"David E.","family":"Messenger","sequence":"first","affiliation":[{"name":"Department of Coloproctology University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niroshini","family":"Rajaretnam","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Devon University Healthcare NHS Foundation Trust  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6032-8580","authenticated-orcid":false,"given":"Dominic A. J.","family":"Slade","sequence":"additional","affiliation":[{"name":"Department of Surgery National Reference Centre for Intestinal Failure, Salford Royal NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CLosure of Abdominal MidlineS Survey (CLAMSS) Collaborative, Abdominal Wall Subcommittees of the Association of Coloproctologists of Great Britain and Ireland (ACPGBI) and the British Hernia Society (BHS), The Dukes' Club","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000141193.08524.e7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.01.012"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138745"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.04.026"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010023\u201002825\u20109"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9600"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010003\u20100161\u2010x"},{"key":"e_1_2_12_9_1","first-page":"673","article-title":"The burst abdomen: a mechanical approach","volume":"63","author":"Jenkins TPN","year":"1976","journal-title":"Br J Surg"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800811114"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60459\u20107"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac194"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010024\u201003025\u20109"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50261"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010014\u20101342\u20105"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac302"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znab205"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2019.09.024"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010021\u201006737\u20101"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2009.189"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac198"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001784"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010023\u201010086\u2010x"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.08.059"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029\u2010017\u20101653\u20104"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010021\u201006238\u20106"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.17081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T08:42:32Z","timestamp":1724143352000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.17081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/codi.17081"],"URL":"https:\/\/doi.org\/10.1111\/codi.17081","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]},"assertion":[{"value":"2024-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}