Abdominal incision and closure. A systems approach.

The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite monofilament continuous one-layer closure of the abdominal aponeurosis as well as several less commonly used principles to minimize the risk of wound infection. The process of graphic display of objectives and alternatives in a surgical procedure or disorder allows one to more sharply focus on alternatives at different steps and more rigidly support them by careful analysis of past experience or review of the literature.