Simple and safe technique for closure of midline abdominal wound dehiscence.

PURPOSE: The aim of this study was to assess an alternative technique for closure of burst abdomen.

METHOD: After reduction of the viscera and toilet of abdominal cavity with debridement of any necrotic tissues in the skin or fascia, the skin was undermined to expose the aponeurosis all-around the defect edges for at least 5-6 cm. The greater omentum is spread in the floor of the wound and fixed to the inner side of the defect. A piece of polypropylene mesh designed according to the size and shape of the defect and sutured to its external edge continuously. Another larger mesh is placed to cover the smaller one and extend over the aponeurosis exceeding the defect edges by at least 5-6 cm and fixed to it.

RESULTS: Six males and five females were included. Mean age was 49.3 year. Mean follow-up period was 17.8 months. Wound infection occurred in 5 patients (45.4%). Mean hospital stay was 18.7 days. No patients developed abdominal compartment syndrome, recurrence or intestinal fistula. No mortality was reported. Two cases developed mild local bulge.

CONCLUSION: This technique provides a simple, safe and effective alternative in the treatment of burst abdomen.