Abdominal wound dehiscence: A review

Wound dehiscence and its complications plague surgical practice. This study aims to identify the clinical features, etiological factors, and preventive measures of abdominal wound dihiscence (AWD). A Medline search from 1966 to February 2004 was done, using the terms abdominal wound dehiscence, burst abdomen, and abdominal wound closure. Accessible full texts of these, relevant references from them, and publications found in medical libraries were studied. Data extracted included authors' names, presenting symptoms and signs of AWD, ages of the patients, presumed etiology of dehiscence, methods of wound closure, and complications and outcome of both the dehiscence and its treatment. These were analyzed under selected headings. Abdominal wound dehiscence is as old as surgery. Predisposing factors are either patient or surgeon related. Despite several incisions and suture materials, controversy remains, with no consensus on the ideal methods or materials for closure of abdominal wounds to prevent dehiscence. At best, the incidence of AWD can be reduced.