A general surgeon closes thousands of abdominal incisions during a typical career, and most surgeons do this quite well. It would be presumptuous to say that this article delineates the technique of wound creation and closure that all surgeons should adopt to minimize acute wound failure. The search for the optimal laparotomy technique has gone on for more than 100 years and will continue. Contained here is a review of what has been studied and what is believed to be true regarding acute wound failure; an opinion is given on which methods currently seem best to avoid and manage this problem.