Study of risk factors in post-laparotomy wound dehiscence

Authors

  • Siddharth Verma Department of Surgery, R. N. T. Medical College, Udaipur, Rajasthan, India
  • Sagar Manohar Patil Department of Surgery, R. N. T. Medical College, Udaipur, Rajasthan, India
  • Ankur Bhardwaj Department of Surgery, R. N. T. Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182764

Keywords:

Abdominal wound dehiscence, Laparotomy, Malnutrition, Peritonitis, Pyoperitoneum

Abstract

Background: Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. The need for this study is to highlight the risk factors for wound dehiscence and remedial measures to prevent or reduce the incidence of wound dehiscence. This will certainly reduce mortality and morbidity in the form of prolonged hospital stay, increased economic burden on health care resources.

Methods: This is a prospective and observational study involving all those who have developed abdomen wound dehiscence after initial surgery, an elaborative study of these cases with regard to date of admission, clinical history regarding the mode of presentation, significant risk factors, investigations, time of surgery and type of surgery postoperatively, study of diagnosis and day of diagnosis of wound dehiscence is done till the patient is discharged from the hospital. The collected data is analysed and statistics were made according to need.

Results: The incidence of abdominal wound dehiscence is more common in male patients in 4th to 5th decade. Patients with peritonitis due to duodenal perforation, complicated appendicitis, pyoperitoneum and intestinal obstruction and carried higher risk of abdominal wound dehiscence. Abdominal wound dehiscence was more common in patients operated in emergency. Patients with intra-abdominal infection, anaemia, hypoalbuminemia, jaundice had higher incidence of wound dehiscence.

Conclusions: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions.

 

Metrics

Metrics Loading ...

References

Carlson MA. Acute wound failure. Surg Clin North Am. 1997;77(3):607-36.

van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, Lange JF. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg. 20101;34(1):20.

Webster C, Neumayer L, Smout R, Horn S, Daley J, Henderson W, Khuri S. Prognostic models of abdominal wound dehiscence after laparotomy. J Surg Res. 2003;109(2):130-7.

Waqar SH, Malik ZI, Razzaq A, Abdullah MT, Shaima A, Zahid MA. Frequency and risk factors for wound dehiscence/burst abdomen in midline laparotomies. J Ayub Med Coll Abbottabad. 2005;17(4):70-3.

Mathur SK. Burst abdomen. A preventable complication, monolayer closure of the abdominal incision with monofilament nylon. J Postgrad Med. 1983;29(4):223.

Spiliotis J, Tsiveriotis K, Datsis AD, Vaxevanidou A, Zacharis G, Giafis K, et al. Wound dehiscence: is still a problem in the 21th century: a retrospective study. World J Emerg Surg. 2009;4(1):12.

Rodríguez-Hermosa JI, Codina-Cazador A, Ruiz B, Roig J, Gironés J, Pujadas M, Pont J, Aldeguer X, Aceroc D. Risk factors for acute dehiscence of the abdominal wall after laparotomy in adults. Spanish Surg. 2005;77(5):280-6.

Graham DJ, Stevenson JT, McHenry CR, Lucas C, Smathers HM. The association of intra-abdominal infection and abdominal wound dehiscence/Discussion. Am Surgeon. 1998;64(7):660-5.

Sivender A, Ilaiah M, Reddy GS. A Clinical study on risk factors causing abdominal wound dehiscence and management. IOSR-J Dent Med Sci. 2015;14(10):18-23.

Parmar G, Gohil A, Hathila V. Burst abdomen: A grave postoperative complication. Internet J Surg. 2008;20:1-8.

Downloads

Published

2018-06-25

Issue

Section

Original Research Articles