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February 14, 1966


JAMA. 1966;195(7):578. doi:10.1001/jama.1966.03100070122040

The "burst abdomen" is an entity as old as laparotomy itself. A survey of the last 15 years showed that mortality following wound dehiscence was 15%, and one of every three survivors was left with an incisional hernia. Moreover, an increase in the frequency of this complication is noted over the past 30 years. In a series of 37,888 laparotomies in the most recent 15-year period, presented in the January issue of the Archives of Surgery, 0.61% resulted in wound disruption.1 A review of the preceeding 15 years showed an incidence of dehiscence in 29,180 incisions to be 0.47%.

Dehiscence is preventable. Over the years, emphasis has been placed on patient age, sex, chronic illness, the presence of malignancy, anemia, or vitamin deficiencies as factors predisposing to wound separation. Obesity, the type of anesthesia, steroid therapy, infection, the position of the wound in the abdominal wall, and the presence

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