Midline Laparotomy

Aponeurosis defines the flat bundles of connective tissue that joins muscle bundles.

Abdominal wall closure refers to the surgical process of closing the layers of the abdominal wall after an incision, typically following laparotomy.

The American Hernia Society (AHS) is a professional organization dedicated to improving hernia care through education, research, and clinical collaboration.

An aponeurosis is a strong, flat sheet of connective tissue that attaches muscle to bone or to other tissues, contributing to abdominal wall strength.

Burst abdomen is a severe complication involving complete fascial disruption after abdominal surgery.

Continuous suturing is a technique where a single suture strand is used to close a wound without interruption.

EHS guidelines are clinical recommendations published by the European Hernia Society that summarize evidence for hernia prevention and abdominal wall management.

Ethicon PDS is a brand name commonly used to refer to polydioxanone (PDO) sutures, which are slowly absorbable monofilament sutures.

The European Hernia Society (EHS) is a professional organization focused on hernia research, education, and clinical practice standards in Europe.

Fascia is a connective tissue layer that surrounds and supports muscles and organs, providing structural strength to the abdominal wall.

Fascial closure is the suturing of the abdominal fascia, the load-bearing layer of the abdominal wall, following surgical incision.

Fascial dehiscence is the separation of the abdominal fascial closure after surgery, leading to loss of wound strength and risk of evisceration or hernia.

Hernia prevention refers to strategies that reduce the risk of postoperative hernia formation, especially incisional hernia after abdominal surgery.

An incisional hernia occurs when abdominal contents protrude through a weakness in a previous surgical incision.

Interrupted sutures consist of individual stitches tied separately along the wound.

Jenkins rule is a surgical closure principle recommending enough suture length—commonly a 4:1 suture-to-wound length ratio—to reduce tension and failure risk.

Laparotomy is an open surgical procedure in which the abdomen is accessed through an incision to diagnose or treat intra‑abdominal conditions.

Laparotomy closure techniques are the methods used to close an open abdominal incision, including choices of suturing pattern, bite size, spacing, and materials.

The large-bites technique uses wider tissue bites placed farther from the wound edge during fascial closure.

The linea alba is a fibrous structure running along the midline of the abdomen where the abdominal muscles meet.

A midline abdominal incision is a midline surgical opening of the abdomen, typically through the linea alba, to provide access for laparotomy.

A midline incision is a surgical cut along the abdominal midline (linea alba) used to access the abdominal cavity in open surgery.

A monofilament suture is made from a single smooth strand of material.

A polydioxanone suture (PDO) is a slowly absorbable monofilament suture material used for closure of the fascia.

SL/WL 4:1 refers to using four times as much suture material as the length of the wound during closure.

The small-bites technique is a continuous suturing method using many small tissue bites placed close to the wound edge during fascial closure.

A surgical site infection is an infection occurring at or near a surgical incision after an operation.

A surgical suturing device is a tool designed to assist surgeons in placing sutures fast and accurately.

The suture length to wound length ratio describes how much suture material is used relative to the length of the incision.

Suture material is the thread or filament used to close surgical wounds.

Suture technique is the method of closing tissue using suture material, including choices such as continuous vs interrupted closure and how stitches are spaced.

Tissue approximation is the alignment of wound edges to promote proper healing.

A wound closure device is a surgical instrument designed to approximate tissue.

Wound dehiscence is the partial or complete separation of a surgical wound after closure.

Wound rupture is a severe postoperative failure of wound integrity, where the closure separates and the incision reopens partially or completely.