It was analyzed the results of clinical and ultrasound examination of the abdominal wall in 180 patients with different surgical diseases of the abdominal cavity. All patients were divided into 3 groups of 60 persons on the basis of the preoperative examination results. The first group included patients without clinical and ultrasound disorders, the second and the third - with mild and severe anatomical and functional failure of the abdominal wall. 20% of patients from the first group had single strain of the abdominal wall after operation without the development of postoperative hernias. 3.3% of patients in the second group had defects and 15% of patient from the same group had severe thinning of the abdominal wall. 45% of patients in the third group had postoperative hernias. Relative and absolute indications for preventive replacement of the abdominal wall were defined.