Page 67 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Evaluation of papers and data extraction
Firstly, the records were screened by title and abstract by two assessors independently (ED, LV). Secondly, the full-texts were divided into two groups and each group was evaluated by two authors (NAH, ED, LV, RF) independently for eligibility with the use of critical appraisal checklist for randomized controlled trials developed by the Scottish Intercollegiate Guidelines Network (SIGN). Only papers rated as ‘acceptable’ or ‘high quality’ by SIGN were included in order to limit the risk of bias. Any disagreement between the two assessors were settled by discussion with a third evaluator (FM, MM). Data was extracted by two authors independently with regard to the prede ned outcomes (NAH, FM) and checked by co-authors (LV, RF). Non-English full-texts were handled with same procedure by two individual assessors outside the author group.
Selection of outcomes to be included in the meta-analysis
In the meta-analysis, sutures were divided into fast-absorbable/slowly- absorbable and non-absorbable sutures regardless of whether the sutures were mono lament or multi lament. Suture methods were divided into interrupted versus continuous suturing and small bites versus big bites technique, regardless of a layered or mass closure technique was used. Emergency and elective laparotomies were pooled in the same analysis, as was all types of incisions (midline, transverse/oblique/paramedian). It was decided only to compare di erent suture types, when the same suture method was used in both arms. Likewise, suture methods were only compared, when the same type of sutures were used for both methods.
Statistical analysis
The outcomes were pooled in conventional meta-analyses and reported as weighted odds ratios (OR) with 95% con dence intervals (95% CI) using the random e ects model and illustrated with forest plots. Heterogeneity was explored using I2 statistics. Funnel plots were used to assess possible publication bias. The Cochrane risk of bias tool was used to assess the risk of bias. Kappa statistics were used to assess the agreement between two assessors. Statistical analyses were performed with Review Manager Software version 5.3 (The Nordic Cochrane Centre, Copenhagen, Denmark).
4
MATCH review
65