Long-Term Results of the STITCH Trial — Still Holding

Objective: To determine the long-term (13 years) incisional hernia rate for patients closed with a small-bite, small spacing technique compared to a large-bite, large spacing technique. Design: Multicenter, double-blind, prospective, randomized clinical trial (The STITCH Trial). Participants: 559 patients who underwent elective midline laparotomy. Methods: In this trial, which completed enrollment in 2012, patients had either 5-mm bites spaced 5 mm with 2-0 polydioxanone suture or 10-mm bites separated by 10 mm with a 1-0 looped suture. Long-term follow-up data were collected from medical records, interviews, physical examination, and imaging. Outcomes were collected by those blinded to the treatment group. The primary outcome was the cumulative incidence of incisional hernia defined as a hernia >2 cm. Quality-of-life scores and self-rated health scores were obtained. A time-to-event analysis was performed to accommodate varying follow-up duration. Results: At 13 years postoperati more...