STRATEGIES FOR CLOSING THE ABDOMINAL WALL AND PREVENTING INCISIONAL HERNIA AFTER LAPAROTOMY
DOI:
https://doi.org/10.56238/levv16n55-076Keywords:
Abdominal Wall Closure, Incisional Hernia, Laparotomy, Small Bites Technique, Prophylactic MeshAbstract
Incisional hernia is one of the most frequent late complications after laparotomy, being associated with impaired quality of life, increased surgical morbidity, and substantial healthcare costs. Accumulating evidence indicates that its occurrence is strongly influenced by abdominal wall closure techniques, perioperative factors, and patient-related risk profiles. This study aims to critically analyze abdominal wall closure strategies and their effectiveness in preventing incisional hernia after laparotomy. This narrative review is based on experimental studies, randomized controlled trials, meta-analyses, international guidelines, and systematic reviews. The findings demonstrate that continuous fascial closure using slowly absorbable monofilament sutures combined with the “small bites” technique significantly reduces the incidence of incisional hernia compared with traditional approaches. Surgical site infection was identified as a major determinant of fascial failure, while prophylactic mesh reinforcement provided additional benefit in selected high-risk patients. In conclusion, the systematic adoption of evidence-based closure techniques, together with rigorous control of risk factors and appropriate patient selection for prophylactic reinforcement, represents an effective, safe, and cost-effective strategy for preventing incisional hernia following laparotomy.
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References
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