Abdominal Midline Incision Closure

Arch Surg. 1987;122(1):120. doi:10.1001/archsurg.1987.01400130126026.
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To the Editor.—Having had an interest in midline incisions of the abdomen for many years, I read with some alarm the article in the December 1985 issue of the Archives entitled "Abdominal Midline Incision Closure."1

It was my impression that it has been known for many years that these simple interrupted sutures in closure of midline incisions lend themselves to an unacceptably high risk of postoperative ventral hernias. For this reason, it was recommended many years ago that interrupted figure-of-eight mattress sutures be used as a means of closure. In my experience, this has eliminated the complication of postoperative ventral hernias.

While the use of a continuous suture may be the closure method of choice in critically ill patients requiring the shortest possible operating time, these patients most certainly have a higher incidence of postoperative wound separation or hernia.

In clean wounds, I cannot see any advantage of


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