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Mass closure of abdominal incisions

Mass closure of abdominal incisions
(A) Smead-Jones closure. Far-far-near-near. Suture passes laterally through rectus sheath and peritoneum and adjacent fat. The suture crosses midline to pick up medial edge of fascia on opposite side of incision.
(B) Alternative closure. Far-near-near-far. The far bite is 1 to 1.5 cm away from the edge. The near bite is 5 mm from the edge.
(C) Running mass closure. Two sutures are used, beginning from each pole of the incision. Sutures are 1 cm away from edge and 1 cm apart. The sutures are tied at the midpoint of the incision.
Courtesy of Therese Trenhaile, MD.
Graphic 51197 Version 3.0