title: Prevention of incisional hernias: how to close a midline incision.
abstract: 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.
authors.affiliation: Department of Surgery and Perioperative Science, Umeå University, SE-901 87 Umeå, Sweden; Department of Surgery, Sundsvall Hospital, SE-851 86 Sundsvall, Sweden. Electronic address: leif.israelsson@lvn.se.
authors.forename: Leif A
authors.initials: LA
authors.lastname: Israelsson
authors.forename: Daniel
authors.initials: D
authors.lastname: Millbourn
mesh_terms: D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation; D006555:Hernia, Ventral / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures; D014945:Wound Healing
keywords: Hernia; Postoperative complications; Surgical wound dehiscence; Surgical wound infection; Wound closure techniques