Closure of Abdominal Wall - Status Quo

The discussion regarding the best way to perform a closure of a laparotomy is still being hotly debated despite the available evidence. It starts with the correct technique of laparotomy, followed by the best possible closure technique and ending with prophylactic mesh augmentation in high-risk patients. The end goal of these individual factors to be considered and the resulting techniques is the avoidance of incisional hernias. Current data in the literature show long-term incisional hernia rates of over 30% - 60% after midline laparotomies over a 3-year period. This high complication rate is unacceptably high despite supposed improvements in closure technique and prophylactic mesh augmentation and calls for future attention to corresponding improvement.

The representation and discussion of the most important aspects of the abdominal wall closure will have to be addressed in this issue. First of all, the choice of access and the localisation of the opening of the abdominal wall, taking into account patient-related factors, is of decisive importance. Performing the approach with the greatest possible respect for anatomical structures and minimising trauma are already predisposing factors for the best possible closure. However, the small bites technique closure technique, which is already being used by many colleagues today, must also fulfil the crucial criteria, which will also have to be addressed in this issue. The use of the best kind of available suture material is another point of optimisation with regard to long-term support in the healing process of the abdominal wall. Finally, the patient related risk assessment leading to an use of a prophylactic mesh augmentation is another step in prevention of incisional hernia occurrence.

This special issue of "Closure of the Abdominal Wall" should include following topics:

- Selection of AW-opening in accordance to surgical procedure
- Opening of AW in respect to the anatomy
- Closure techniques
- Mesh augmentation
- Care and Treatment following AW closure

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Article types and fees

This Special Issue accepts the following article types, unless otherwise specified in the Special Issue description:

• Brief Research Report
• Case Report
• Commentary
• Editorial
• Letter to the Editor
• Mini Review
• Opinion
• Original Research
• Review

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Special Issue accepts the following article types, unless otherwise specified in the Special Issue description:

• Brief Research Report
• Case Report
• Commentary
• Editorial
• Letter to the Editor
• Mini Review
• Opinion
• Original Research
• Review

Keywords: laparotomy closure, small bites technique, large bites technique, propyhlactic mesh, incisional hernia prevention