Evaluation of Potential Risk Factors Causing Abdominal Wound Dehiscence

Santosh Kumar Santosh Kumar,Ajay Kumar Jha Ajay Kumar Jha,Ajit Kumar Sinha Ajit Kumar Sinha

doi:10.47008/ajs/2020.3.1.5

Santosh Kumar Santosh Kumar, Ajay Kumar Jha Ajay Kumar Jha + Show 1 more

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https://doi.org/10.47008/ajs/2020.3.1.5

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Abstract

Background: Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. The aim of this study was to highlight the risk factors for wound dehiscence and remedial measures to prevent or reduce the incidence of wound dehiscence. Subjects and 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 carried higher risk of abdominal wound dehiscence. Abdominal wound dehiscence was more common in patients operated in emergency. Patients with intra-abdominal infection, anaemia, hypoalbuminaemia, jaundice had higher incidence of wound dehiscence. Conclusion: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions.

Highlights

IntroductionAbdominal wound dehiscence (burst abdomen, fascial dehiscence) is a severe postoperative complication with mortality rates reported as high as 45%. [1–3] Abdominal wound dehiscence can result in evisceration, which require immediate treatment
Abdominal wound dehiscence is a severe postoperative complication with mortality rates reported as high as 45%. [1–3] Abdominal wound dehiscence can result in evisceration, which require immediate treatment
Conditions associated with increased risk of wound dehiscence are anaemia, hypoalbuminaemia, malnutrition, malignancy, jaundice, obesity and diabetes, male gender, elderly patients and specific surgical procedures as colon surgery or emergency laparotomy

Summary

Introduction

Abdominal wound dehiscence (burst abdomen, fascial dehiscence) is a severe postoperative complication with mortality rates reported as high as 45%. [1–3] Abdominal wound dehiscence can result in evisceration, which require immediate treatment. Abdominal wound dehiscence (burst abdomen, fascial dehiscence) is a severe postoperative complication with mortality rates reported as high as 45%. [4] Despite advances in perioperative care and suture materials, incidence and mortality rates with regards to abdominal wound dehiscence have not significantly changed over the past decades. This may be attributable to increasing incidences of risk factors within patient populations outweighing the benefits of technical achievements. The goal of the underlying study was to evaluate possible risk factors for abdominal wound dehiscence. Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. Conclusion: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions

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