Objective: This study evaluated preoperative assessment, optimal surgical techniques, and postoperative management of abdominal wall reconstruction and total abdominal wall defects after laparotomy. Methods: Eight patients who underwent reconstruction at our department between August 2017 and April 2024 were included. Results: The male-to-female ratio was 1:1, with a mean age of 66 years and BMI of 22.1. Five patients had gastrointestinal cancer, one had renal cancer, and one underwent cardiac surgery after laparotomy. Surgical site occurrences（SSO）were observed in three patients. One patient had comorbidities of chronic obstructive pulmonary disease and diabetes mellitus. The mean size of the abdominal wall defect was 7.3 × 4.1 cm². The defects were located in the midline, upper abdomen, and lower abdomen in three, three, and two cases, respectively. Reconstruction included local skin valves in four cases and rectus abdominis stem valves in four cases. The mean observation period was 18 months. All the patients underwent successful abdominal wall reconstruction. Discussion: Favorable outcomes were achieved by optimizing preoperative evaluation of the defect, selecting surgical procedures with consideration of SSO, and improving postoperative management.