Abdominal wound closure using a nonabsorbable single-layer technique

A continuous 1-layer abdominal closure using number 2 polypropylene was employed in 200 unselected consecutive patients. All the patients had lower midline incisions and were high-risk, and the majority (82%) had some form of gynecologic malignancy. A significant number had received preoperative radiotherapy (22.5%), another 18% were obese (over 90 kg), and 15% had undergone bowel surgery. The complete evisceration rate in the series was 0. A total of 17 (8.5%) wound infections occurred and 10 (5%) postoperative ventral hernias were seen over a 2-year period. Five of these were incisional and 5 were paraincisional; 1 of each required surgical repair. The method is simple, time-saving, and successful; it carries a low complication rate for patients at high risk for postoperative evisceration.