There has been a resurgence of interest recently in the optimal method of closure of the midline abdominal wound. The focus has been on the high-risk patient in particular. The controversy centers on interrupted versus continuous fascial closure and the choice of suture material. For three years on a gynecologic cancer service, running mass closure with delayed absorbable suture (Polyglactin) was used. Two hundred fifty-six patients were evaluable for analysis. The minimum follow-up time was two years. There was no wound dehiscence. Fourteen patients (5.5%) developed incisional hernias. The mass closure technique using delayed absorbable suture was effective in very-high-risk patients.