**5. Evidence based guidelines with wound closure recommendations**

In addition to the 2015 European Hernia Society guidelines on the closure of abdominal wall incisions, there are two other evidence-based guidelines with specific recommendations for choice of wound closure materials [11, 41]. Both focus on reducing the risk of SSI. The 1999 CDC Guidelines for Prevention of Surgical Site Infection were finally updated in 2017 [41]. The update did not reevaluate a number of strong recommendations from the 1999 version as they were deemed to be accepted practice for the prevention of SSI. The 2017 update does however include a new recommendation for the choice of wound closure material—there is a specific Category II recommendation to "Consider the use of triclosan-coated sutures for the prevention of SSI" [41].

In addition to the CDC 2017 guideline, the WHO Global Guidelines for the Prevention of Surgical Site Infection 2018), also included a recommendation for wound closure: "The panel suggests the use of triclosan-coated sutures for the purpose of reducing the risk of SSI, independent of the type of surgery" [11]. This recommendation was categorized as Conditional Strength based on Moderate Quality of Evidence [11].
