Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Best Techniques for Abdominal Incision Closure

Cochrane; 2017 Nov 3; Patel, et al

When attempting to close abdominal incisions after surgery, monofilament sutures reduce the occurrence of incisional hernia, according to a recent Cochrane review. The same analysis also concluded that absorbable sutures reduce the likelihood of chronic wound drainage, including sinus or fistula formation.

  • The Cochrane team reported on 55 studies that included over 19,000 patients.
  • The studies looked at a variety of suture materials, closure techniques, and types of surgery.
  • Absorbable sutures were compared to permanent sutures.
  • Closing all the anatomical layers of the abdominal wall at the same time was compared to closure of individual layers.
  • Continuous closure was compared to interrupted closure.
  • Monofilament sutures were compared to braided multifilament sutures.
  • Sutures that maintain their tensile strength for >30 days (slow absorbable) were compared to those that lost strength within 30 days.


Patel SV, Paskar DD, Nelson RL, Vedula SS, Steele SR. Closure methods for laparotomy incisions for preventing incisional hernias and other wound complications. Cochrane Database of Syst Rev. 2017, Issue 11. Art. No.: CD005661. doi:10.1002/14651858.CD005661.pub2.