A Nested Case Control Study of the Abdominal Wound Dehiscence in a Rural Hospital in South India

Abstract

The abdominal wound dehiscence is defined as partial or complete separation of the fascial layers of the abdomen. Also been described as fascial dehiscence, postoperative eventration, abdominal wound disruption, broken-down abdominal wounds and burst abdomen. The incidence rate mentioned in the international literature ranges from 0.4-3.5%. The reported mortality rates of the complication are as high as 45% associated with the severity. In our teaching hospital which is a Secondary level hospital in a rural area, an overall incidence of 6% of abdominal wound dehiscence is observed in comparison to others. In this study, many risk factors were observed to be the cause for the development of abdominal wound dehiscence. Many of the patient related risk factors were proved to be the cause for the development of dehiscence. Hypoproteinemia, Anaemia, Renal failure, uremia, presence of malignancy, associated diseases like Diabetes, hypertension, COPD and immunocomprimised state of the patient, factors which increase intra abdominal pressure like post operative cough, vomiting, abdominal distension and urine retention, development of the wound infection plays a role in the development of wound dehiscence.