ABSTRACT
The aim of an incision is to provide: maximal access, the maximum opportunity for healing, and good cosmesis. This chapter provides the important principles of wound closure. To close a laparotomy wound, the mass-suture closure technique would be used, including both peritoneum and rectus sheath in the suture. The suture should be at least four times the length of the incision, and bites should be taken 1 cm from the wound edge at 1-cm intervals. Dehiscence occurs when a wound fails to heal in apposition and there is partial or total disruption of the surgical wound. When this occurs in a laparotomy wound, there may be protrusion of omentum or abdominal organs. The signs that would indicate impending wound dehiscence are, low-grade pyrexia, bloodstained fluid from the wound, abdominal distension, and abdominal pain. Dehiscence of a laparotomy wound is a surgical emergency, as it is associated with a mortality of 30–40%.
