Summary of findings 2. Mass versus layered closure for laparotomy incisions.
| Mass versus layered closure for laparotomy incisions | |||||
| Patient or population: patients undergoing laparotomy incisions Setting: community and hospital‐based, outpatient and inpatient, worldwide Intervention: en masse for abdominal closure Comparison: layered closure for abdominal closure | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with layered closure | Risk with mass closure | ||||
| Incisional hernia follow‐up: 1 year | Study population | RR 1.92 (0.58 to 6.35) | 1176 (5 RCTs) | ⊕⊝⊝⊝ Very low1,2,3 | |
| 27 per 1000 | 51 per 1000 (15 to 169) | ||||
| Wound infection at last follow‐up | Study population | RR 0.93 (0.67 to 1.30) | 2926 (11 RCTs) | ⊕⊕⊝⊝ Low1,4 | |
| 114 per 1000 | 106 per 1000 (76 to 148) | ||||
| Wound dehiscence at last follow‐up | Study population | RR 0.69 (0.31 to 1.52) | 2863 (11 RCTs) | ⊕⊕⊕⊝ Moderate1 | |
| 23 per 1000 | 16 per 1000 (7 to 35) | ||||
| Sinus or fistula formation at last follow‐up | Study population | RR 0.49 (0.15 to 1.62) | 1076 (6 RCTs) | ⊕⊕⊝⊝ Low1,2 | |
| 49 per 1000 | 24 per 1000 (7 to 79) | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | |||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | |||||
1Downgraded one level for serious risk of bias (includes at least one study with overall high risk of bias). 2Downgraded one level for inconsistency (I2 = 61%). 3Downgraded one level for imprecision (overlapping no effect). 4Downgraded one level for inconsistency (I2 = 50%).