Abdominal incision wound breakdown

Wound disruption remains a major complication in abdominal surgery. The complication rate is significant, and in cases of dehiscence the death rate is high, underscoring the importance of prevention and proper treatment of such complications. The prompt diagnosis and treatment of superficial wound disruption can result in minimal complications or delays in recovery. Simple measures such as wound care and liberal use of delayed reclosure have greatly decreased such complications. Much more devastating is the occurrence of fascial dehiscence. The emphasis should be on vigilance in technique to prevent such events. It is entirely within our ability to eliminate most early dehiscences with proper attention to suture technique, stitch placement, and proper surgical technique. Although rare, dehiscence generally occurs when other comorbidities narrow the margin for errors in technique. The associated comorbid risk factors that accompany dehiscence make these patients the least likely to survive such a complication. Most such patients will require a prolonged hospital stay and intensive measures at minimum. Proper management requires familiarity with the range of options for repair; in complicated and infected cases, consultation with others experienced in trauma and plastic surgery and a team approach are needed for successful outcomes.