Abdominal wound dehiscence is a significant problem facing all surgeons who undertake abdominal surgery on a regular basis. Traditionally, it is said to occur when all layers of an abdominal mass closure fail and the viscera protrude externally (associated with 30% mortality).

It can be subdivided into superficial, in which the skin wound alone fails and complete, implying failure of all layers.

Factors that increase the risk are:

• Malnutrition
• Vitamin deficiencies
• Jaundice
• Steroid use
• Major wound contamination (e.g. faecal peritonitis)
• Poor surgical technique (Mass closure technique is the preferred method-Jenkins Rule)

PC

• Sudden sharp pain at the wound site
• Serous drainage from the wound
• Fever
• Increased abdominal girth
• Visible internal tissues or organs
• Dehiscence often occurs within one week post-operation, but the timing can vary

Investigations

• Wound cultures to identify any bacterial infection