Closure of the abdominal fascia

By Nikolaj Nerup, MD, PhD and Peter Olsen Svenningsen, MD 

The small steps technique should be used to close a midline abdominal laparotomy incision using continuous suturing with a slowly absorbable (polydioxanone) suture. A wound-suture length ratio of minimum 1:4 is well documented to be preferred in both elective and emergency surgery.