My use of the various filigrees in twenty-two cases has led to certain definite conclusions with reference to the mechanical side of the question.
A scar, no matter how thin, if prevented from stretching by embedded wires, constitutes a reliable, integral portion of the abdominal wall.
A ready-made filigree answers all possible requirements; hence, the construction of one in the wound constitutes an unnecessary prolongation of the operation.
Since scars tend to stretch laterally, the filigree need be made up of only cross wires, held together in the middle by one single-twisted strand, following the direction of the suture line.1
The accompanying illustration will serve well to give an idea of this filigree, which I devised more than five years ago, and which I have used since that time with growing enthusiasm. To demonstrate the firm hold of new-formed scar tissue on the loops, I can do no better than
BARTLETT W. FIVE YEARS' EXPERIENCE WITH AN ORIGINAL FILIGREE INTENDED TO PREVENT AND TO CURE ABDOMINAL HERNIÆ.. JAMA. 1906;XLVII(10):754-760. doi:10.1001/jama.1906.25210100026002f