To the Editor.—We developed a technique for the secure closure of abdominal incisions using mass approximation of the tissues by a continuous, looped, monofilament, nonabsorbable suture. In a prospective series of 284 cases followed for at least six months, an early dehiscence rate of 0.7% and a late hernia rate of 1.1% were detected. These figures are similar to rates cited in the recent literature using other methods of closure.
Incisions were approximated as a mass closure incorporating both fascia and peritoneum in a running suture. The suture was constructed of 183 cm of 0 nylon swagged onto a needle (XLH) to provide a usable suture length of 91.5 cm. The suture was prepared by Ethicon (Somerville, NJ) for this purpose (Fig 1). We attempted to obtain a suture-to-wound-length ratio of at least 3:1 to achieve a firm but relaxed closure. When, for technical reasons, the peritoneum could not