The object of this article is to report a case of extensive destruction of the skin and the subcutaneous tissue in an operative wound closed after a routine removal of a gangrenous appendix and to discuss the observations already reported in medical literature regarding this rare but definite clinical entity. The case to be described is from the Mary McClellan Hospital, service of Dr. Denver M. Vickers, and it is through Dr. Vickers' cooperation that this report is made possible. All surgical procedures were carried out under his direction or by him personally, and his recollection of a similar account in the literature led to the finding of the first useful understanding of the problem.
Necrosis of a wound as a postoperative complication has been described enough in medical periodicals to be established as a definite entity with a definite mode of progression. Its appearance, as will be shown, is