Abdominal wall defects: pathogenesis, prevention and repair

Abdominal wall defects often complicate the postoperative course of patients after abdominal surgery in the form of wound dehiscence in the short term and incisional hernia in the long term. Prevention and treatment remain a significant challenge to surgeons. This paper provides an update regarding the most recent insights regarding the pathogenesis of these common abdominal wall defects. In the ‘How to’ sections, the best methods of opening and closing the abdomen are presented, with a focus on prevention of short- and long-term complications. Also, the various options and indications for synthetic and autologous abdominal wall reconstructions are discussed. Finally, a treatment algorithm based on our extensive experience and the best available evidence in the literature is presented for the various forms of incisional hernias discussed in this paper.