Burst abdomen-A preventable morbidity

A burst abdomen is considered present, when intestine, omentum or other viscera's were seen in the abdominal wound following obstetric surgery. In our country no study found, but observational incidence in the tertiary hospital varies between 0.2-3%. It occurs mostly between the sixth and eight day after operation. Factors relating to the incidence of burst abdomen are suture, closure, incision, coughing, vomiting, distension, obesity, jaundice, malignancy, diabetes mellitus, hypoproteinaemia, anaemia, immuno-compromised patients and wound infection. During the period of February 2001 to February 2006 four cases of burst abdomen were managed in cooperation with team of surgery department. In these cases wound were closed by "May/Mary closure". Abdominal wound dehiscence remains a major cause of morbidity following any laparotomy whether elective or emergency. We should correct the primary risk factors for wound dehiscence. Transverse incisions are generally considered to dehiscence much less than the vertical incision. The suture should have excellent handling and knotting. Its prevention is important to reduce postoperative morbidity, mortality and increased cost of care both in terms of increased hospital stay and treatment of the complication.