[Development and pathophysiology of abdominal wall defects].

Repair of abdominal wall hernias is the most frequently performed operation in surgery. Primary hernias arise at anatomical weak points; incisional hernias result from laparotomies. As the fascia heals slowly, the suture should be strong enough to withstand the intraabdominal pressure. Complications in wound healing may lead to a hernia, especially when absorbable sutures have been used. The rate of incisional hernias is technically influenced by the type of incision, the suture technique, and the suture material. To achieve adequate repair it is often necessary to change the principles of abdominal wall closure, for example by using alloplastic material. The meshes reinforce the architecture of the abdominal wall both by pure mechanical means and by induction of a stable scar formation (polypropylene, polyester).