Investigations of the causes of disruption of abdominal wounds have emphasized the importance of the premature absorption of catgut, improper wound closure, distention, postoperative coughing and the delayed fibroplasia so commonly encountered in this accident. It has been stated that some factor associated with the general state of the patient is important in the predisposition of the tissues to undergo the normal processes of wound repair.
That catgut loses most of its strength when exposed to tissue fluids in much less time than many reputable manufacturers give for its absorption was borne out, in both the experimental animal and man, by studies reported from this department in 1936.1 More recently, three of us2 found that the normal processes of wound repair could be greatly retarded by experimentally producing hypoproteinemia in the dog. That other factors are important in certain instances of wound disruption we do not doubt.
THOMPSON WD, RAVDIN IS, RHOADS JE, FRANK IL. USE OF LYOPHILE PLASMA IN CORRECTION OF HYPOPROTEINEMIA AND PREVENTION OF WOUND DISRUPTION. Arch Surg. 1938;36(3):509-518. doi:10.1001/archsurg.1938.01190210138009