[Prevention of postoperative wound dehiscence. Comparative study of polyglactin 910 mesh and total reinforced...

Postoperative wound dehiscence is a serious complication. Various surgical procedures have been proposed to prevent it but only few studies have compared their effectiveness. The authors report a retrospective study on 292 high risk patients operated between 1980 and 1988. These patients were divided in two groups according to the methods of abdominal wall support: 226 patients (group I) with total reinforced extraperitoneal sutures and 66 (group II) with a polyglactin 910 mesh. Preoperative risk factors, surgical pathology and the incisions performed were similar in the two groups. Only two parameters were different: the number of previous operations and emergency surgery which were more frequent in group II (p less than 0.05). Fourteen patients in group I developed postoperative wound dehiscence and none in group II (p = 0.02). Nine of these patients were reoperated with a mortality of 28.5%. The frequency of the other complications was similar in the two groups. Polyglactin 910 mesh was more effective than total reinforced extraperitoneal sutures in the prevention of post operative wound dehiscence justifying its use in high risk patients.