Clinical study of factors influencing wound dehiscence after emergency exploratory laparotomy

Ankit Kamboj; A. R. Bansal; Harsha Kamalhans; Joy Bansal; Simon Lanah

doi:10.18203/2349-2902.isj20251534

Authors

Ankit Kamboj Department of General Surgery, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
A. R. Bansal Department of General Surgery, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India https://orcid.org/0000-0001-9001-3195
Harsha Kamalhans Department of General Surgery, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India https://orcid.org/0009-0008-5318-8189
Joy Bansal Department of General Surgery, Maharishi Markandeshwar University, Solan, Himachal Pradesh, India
Simon Lanah Department of General Surgery, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20251534

Keywords:

COPD, Diabetes mellitus, Emergency laparotomy, Hypoalbuminemia, Neoplasia, Superficial dehiscence, Wound dehiscence

Abstract

Background: Wound dehiscence is a major complication following surgery, particularly after emergency exploratory laparotomies. It occurs due to the failure of proper wound healing, resulting in higher patient morbidity, longer hospital stays and increased healthcare costs. The risk factors associated with wound dehiscence is crucial for enhancing patient outcomes and thus minimizing complications. The present study was thus planned to identify and address.

Methods: A total of 100 consecutive patients were studied in the period from May 2022 to April 2023 who underwent emergency laparotomy for conditions like intestinal perforation, obstruction and ruptured appendix were assessed for risk factors associated with wound dehiscence including age, BMI, diabetes mellitus, neoplasia, preoperative respiratory conditions, contamination during surgery, serum albumin, serum creatinine and anaemia. The incidence of wound dehiscence was recorded from postoperative days 3 to 7.

Results: Out of 100 patients, 35 had superficial wound dehiscence, while 6 developed deep dehiscence. There was significant correlations between wound dehiscence and low serum albumin levels as well as preoperative respiratory abnormalities and associated comorbidities like DM, neoplasia. Contamination with either bilious or fecopurulent material significantly increased the risk of wound dehiscence.

Conclusions: Wound dehiscence remains a significant concern following emergency laparotomy. Factors like hypoalbuminemia, respiratory abnormalities and intraoperative contamination play a pivotal role in causing wound dehiscence following exploratory laparotomy. Early identification and management of these risk factors along with appropriate postoperative care are essential in reducing the incidence of wound dehiscence.

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