Burst abdomen usually occurs on which post operative day

Ans is 'b' i.e., 6-8 [Ref: Bailey & Love 25th/e p.986 & 24th/e p. 1290; Sabiston, 18th/e p.330 & 17th/e p299))Burst Abdomen* In 1-2% of cases of laprotomy, mostly between the sixth and eighth day after operation, an abdominal wound bursts open and viscera are extruded. (Bailey 25th edn Pg: 986)* Burst abdomen occurs mostly between the 7th and 10th day after operation (but may occur anytime after surgery from 1 to more than 20 days) (ref: Sabiston 18/e)* The disruption of the wound tends to occur a few days beforehand when the sutures apposing the deep layers (peritoneum, posterior rectus sheath) tear through or even become untied.Factors associated with burst abdomen (abdominal dehiscence)a) Suture material:* Chromic catgut is associated with high incidence of burst abdomen as it gets absorbed very quickly (in 8-9 days). An ideal suture material for abdominal closure should neither disappear nor lose its tensile strength until the wound has regained near-normal tensile strength.* Nonabsorbable, monofilament materials are found to be good.b) Method of closure* Single layer closure has lower incidence than multilayer closure* Interrupted suture is better than continuous suturec) Drainage* Drainage directly through the wound leads to a higher incidence of burst than employing drainage through a separate (stab) incision.d) Incision* Midline & vertical incisions are more prone to burst than transverse incisionse) Reason for initial operation* Deep wound infection is prone to cause burst abdomen* Operations on pancreas with leakage of enzymes favours dehiscencef) Wound complication* Hematoma, infectiong) Increased intraabdominal pressure* Ascites, distended bowel, coughing, vomitingh) General condition of the patient* Obesity, jaundice, malignant disease, hypoproteinemia and anemia predispose burst abdomen.