Abdominal wound disruption.

Abdominal wound disruption occurred in 6 cases in a series of 2500 consecutive abdominal laparotomies. A prospective study of 900 laparotomies utilizing polyglycolic acid suture material and the Smead-Jones closure technic was carried out over a period of 1 year with a reduction in the incidence of wound disruption from 0.4 to 0.1%. Etiologic factors placing patients in a high-risk category for disruption are identified, and specific prophylactic measures are discussed. Prevention of catastrophic disruption is advocated because of its high mortality rate, averaging 20%.