Wound Dehiscence

ALTHOUGH a case of "burst abdomen" is an infrequent event in the life of any one surgeon, the result of this postoperative complication is often catastrophic. At the Massachusetts General Hospital, it is accompanied by a mortality rate of 15%. A yearly review of the increasing number of laparotomies performed on the ward and private services of the hospital reveals a disproportionate rise in the incidence of wound dehiscence over the past 15 years. In this paper, wound dehiscence describes the separation of all layers of the abdominal incision, including the peritoneum, after intra-abdominal surgery (Fig 1). Wallace,1in an unpublished study at this hospital in 1945 covering the 16 years 1930 through 1945, found 137 wound dehiscences following 29,180 laparotomies, an incidence of one dehiscence in every 213 wounds (0.47%). At that time he made an attempt to distinguish the importance of the various factors affecting this complication.