A novel approach to repair of wound dehiscence in the complicated patient

Wound dehiscence following abdominal surgery is a rare but deadly complication and management can be challenging. Multiple risk factors can increase the likelihood of encountering a wound dehiscence, including genetic predisposition. One such genetic disorder is type IV Ehlers-Danlos syndrome, which is associated with extreme friability of tissues, including skin and fascia. Due to the friability of the tissue, closure of the wound with conventional techniques is frequently associated with reoccurrence of the dehiscence. Here, we describe a patient with an abdominal wound dehiscence who was treated successfully with a novel closure technique using the Quill SRS™ [Angiotech] barbed suture. The type of stitches and the technique employed allowed diffusion of wound forces away from the edges for distribution to a larger surface, thus decreasing the chances of ripping the skin in this challenging patient.