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February 1967

Wound Dehiscence: Increased Intra-abdominal Pressure After Repair of Diaphragmatic Hernia

Author Affiliations

Jerusalem, Israel
From the Department of Surgery, Rothschild-Hadassah University Hospital, Jerusalem. Dr. Bitterman is presently with the Section of Surgical Research, Mayo Clinic, Rochester, Minn.

Arch Surg. 1967;94(2):178-180. doi:10.1001/archsurg.1967.01330080016005

IN A SURVEY of patients with diaphragmatic hernia who were operated on, through an abdominal approach, in the Hadassah University Hospital between 1961 and 1965, we noticed a significant incidence of postoperative wound dehiscence. On the assumption that this was the result of increased intra-abdominal pressure following the reposition of the herniated organs into the abdominal cavity, we decided to compare the frequency of wound dehiscence in these patients and in a control group with similar upper abdominal incisions for other conditions.

Material and Methods  Forty-four patients with sliding hiatus hernias and two with paraesophageal hernias, all of whom were operated on through an upper midline abdominal incision, were compared with 115 randomly selected patients operated on during the years 1963 and 1964, on whom similar incisions and closure methods were used for a variety of upper gastrointestinal conditions (Table 1). None of these patients had evidence of malignant disease.

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