Allergy as an Explanation of Dehiscence of a Wound and Incisional Hernia

Disruption of Abdominal Wounds

“…22 The present series consists of 45 cases of wound disruption occurring in a series of I700 consecutive abdominal operations performed on the General Surgical Service during the interval from January I, I946 through February 28, I949. For the most part this period corresponds to the newly instituted resident training program.…”

“…36), closed with interrupted chromic catgut in layers plus heavy braided silk retention sutures, disrupted on the sixth postoperative day when the patient 22) occurred on the twelfth postoperative day in a debilitated patient on whom a radical pancreaticoduodenectomy had been performed and whose wound, closed in layers with cotton, contained a colostomy loop and drains allowing the escape of biliary and pancreatic secretions through it. There were no significant mechanical factors present here and poor healing, infection, a viscus in the wound and drainage of digestive enzymes seem to be the important items.…”

Adverse reaction to surgical sutures in thyroid surgery

“…Hinton, in 1937,7 mentioned that 3% of the patients who had undergone abdominal surgery had wound adhesion develop, with a 16% mortality rate. The incidence of this complication was reduced considerably after other kinds of sutures were used.…”

“…Getzen and Janse1 ascribed wound healing complications to an allergic reaction. They studied 205 patient who had undergone laparotomy.…”

“…However, an adverse reaction to surgical sutures was more common in the past than it is today. This hazardous reaction was noted to cause disturbance in wound healing, wound dehiscence, and even intestinal obstruction 1, 2. Today, we rarely find reports on adverse reactions to sutures, mainly because of the development of new, less reactive synthetic sutures, such as silk or Vicryl.…”