New developments in abdominal wall closure

A perspective on the newer techniques and techniques and recommendations in abdominal wall closure as described in the English-language literature is given. Primary closure of midline incision with running suture should be pe rformed with a suture length to wound length ratio in the range of 4-5 to 1 ; this appears to be the most important step the surgeon can take to avoid dehiscence and/or hernia. The choice of suture material does not appear to be crucial with regard to the prevention of wound failure. Anecdotal experi ence has suggested that the specific technique of mesh placement in incisio nal herniorhaphy is important to prevent recurrence. Difficult abdominal cl osure can be handled by one of a number of temporary abdominal closure tech niques.