In reply
The aim of our clinical trial was to investigate if closure of midline incisions with an SL:WL ratio of at least 4 should be done with small or large tissue bites. The rate of both wound infection and incisional hernia was then lower with small tissue bites.1 Experimental findings of a higher tissue breaking strength with small tissue bites compared with large bites certainly offer an explanation for the lower rate of incisional hernia.2,3