ABSTRACT
This chapter explores the evidence behind strategies attempting to reduce the risk of incisional hernia formation following abdominal surgery. The midline incision is preferred for entry into the abdomen, especially for emergency laparotomies, because of its ease, speed, bloodless planes and excellent exposure. In an attempt to reduce the rate of SSIs, a well-recognised risk factor for incisional hernia development, sutures have been produced that have been coated in triclosan antimicrobial agent. Many surgeons advocate the avoidance of certain activities post-operatively that would place a strain on their abdominal wall, such as coughing, sneezing and straining, or taking measures to hold their abdomen when doing so. Surgical teaching for abdominal wall closure has adhered to ‘Jenkin's rule’ in order to decrease the risk of dehiscence which advocated a mass closure technique with a continuous suture, with a suture length four times the length of the incision and with bites taken 1 cm from the wound edge at 1 cm intervals.
