Prevention of incisional hernias: how to close a midline incision

Leif A Israelsson, Daniel Millbourn
Surgical Clinics of North America 2013, 93 (5): 1027-40
The development of wound complications is closely related to the surgical technique at wound closure. The risk of the suture technique affecting the development of wound dehiscence and incisional hernia can be monitored through the suture length to wound length ratio. Midline incisions should be closed in one layer by a continuous-suture technique using a monofilament suture material tied with self-locking knots. Excessive tension should not be placed on the suture. Closure must always be with a suture length to wound length ratio higher than 4.

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