Historically we were taught as surgeons that 1-centimeter bites that between suture throws on a Pfannenstiel (low transverse) fascial closure was enough to prevent hernia formation and optimize facial healing. But is this still evidence based? We can extrapolate data from a May 2026 systematic review/meta-anlysis as well as a separate study from the Dutch published in 2021. Both of these studies were in the journal Hernia. The evidence does favor one technique over the other! Listen in for details.

1. Golling M, Baumann P, Kuger F, Fortelny RH. Impact of the SUture BIte TEchnique on clinical outcomes after midline laparotomy closure: SUBITE-a systematic review and meta-analysis. Hernia. 2026 May 19;30(1):221. doi: 10.1007/s10029-026-03700-z. PMID: 42154339; PMCID: PMC13186860.

2. Paulsen CB, Zetner D, Rosenberg J. Variation in abdominal wall closure techniques in lower transverse incisions: a nationwide survey across specialties. Hernia. 2021 Apr;25(2):345-352. doi: 10.1007/s10029-020-02280-w. Epub 2020 Aug 8. PMID: 32770366.