Burst abdomen after laprotomy takes place after -

Ans. is 'b' i.e., 6-9 days "Dehiscence most often develops 7 to 10 days postopera lively but may occur anytime after surgery, from 1 to more than 20 days." - Sabistono Burst abdomen or wound dehiscence refers to postoperative separation of the abdominal masculoaponeurotic layers.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 ofclosure* Single layer closure has lower incidence than multilayer closure* Interrupted suture is better than continuous suture.c) 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 incisions.e) Reason for initial operation* Deep wound infection is prone to cause burst abdomen.* Operations on pancreas with leakage of enzymes favours dehiscence.f) 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 abd.