BURST ABDOMEN or WOUND DEHISCENCE

 

BURST ABDOMEN or wound dehiscence is a term used in surgery to denote a condition where after surgery the abdominal walls of a patient cannot hold the excess edematous fluid in the peritoneal cavity and separate at the incision site. That is, the muscles and the fascia that make up the abdominal wall give away to the increasing pressure inside the abdomen spilling its contents.Though a really terrifying condition for the onlookers it is a treatable condition unless complicated by other comorbid conditions like diabetes.

It occurs in 1-2% of the cases of operations on the abdomen mostly between the 6th and 8th day after the surgery.The factors relating to the incidence of burst abdomen are:

Choice of suture material-higher incidence with the use of catgut than with the use of non-absorbable monofilament

Method of closure-Interrupted suturing has a lower incidence than the continuous suturing

Drainage- drainage directly through a wound has a higher incidenceOperations on the pancreas have higher incidence:

Coughing,Vomiting and distension post operatively can lead to burst abdomen

Obesity, Jaudice, malignant disease ,hypoprotinemia and anaemia are also important risk factors

Clinical features:

serosanguinous (pink )coloured discharge is an important forerunner in 50%.Patient might complain of feeling of something giving way.

Treatment is an emergency operation to replace the bowel, relieve any obstruction and resuture the wound. A second incidence is rare.