Wound necrosis due to ischemia in a "watershed" area

On the right side of the patient's laparotomy incision, note the superficial ischemia starting inferior to the previous Kocher incision (arrow), which limits blood supply from the right superior epigastric artery. Unfortunately, branches of the inferior epigastric artery had also been compromised by the previous stoma (dashed arrow), leaving this right side of the wound edge (between the length of the double arrow) necrotic.