Wound dehiscence. Pathophysiology and prevention.

A review of 32 abdominal wound dehiscences in a five-year period shows an incidence of 0.51%. Important factors are preexisting pulmonary disease, "malnutrition," intraoperative contamination (often minimal), gastrointestinal distention, and aggressive tracheobronchial toilet in the postoperative period. Incision direction and type of closure have little influence on dehiscence rates. Wound dehiscence results in a substantial prolongation of hospital stay. Promptly recognized and treated, wound dehiscence is no longer a highly lethal complication.