|Authors||Abbott DE, Dumanian GA, Halverson AL|
|Journal||Am Surg Volume: 73 Issue: 12 Pages: 1224-7|
|Publish Date||2007 Dec|
Many studies identify risk factors for dehiscence, but a paucity of data exist suggesting an optimal treatment strategy. This study examines repair of abdominal wound dehiscence, comparing closure and interposition of mesh. We conducted a retrospective review of 37 individuals who suffered a wound dehiscence after laparotomy. Outcomes of repairs with either primary closure or polyglactin mesh interposition were examined. Twenty-seven individuals underwent repair with primary closure. Twelve of these individuals suffered repeat wound dehiscence; 10 were treated with repeat fascial closure, 2 with polyglactin mesh interposition. Seven individuals initially underwent successful repair with polyglactin mesh interposition; all subsequently had their hernias repaired. Three patients had minor fascial separation managed nonoperatively. Primary closure is associated with a relatively high rate of recurrent wound dehiscence. Closure with polyglactin mesh interposition has a higher initial success rate, but necessitates additional surgeries for repair of the abdominal wall defect.