Abstract
Background Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place. It is a major cause of postoperative morbidity and mortality in sub-Saharan Africa including Ethiopia, and little is known about its prevalence and related factors in the study area. Objectives The aim of this study is to assess the magnitude of abdominal wound dehiscence and related factors on patients operated at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods A hospital-based retrospective review of the chart was carried out by using the data covering three years (September 2014–September 2017) period. Data were collected from hospital medical records of sampled patients such as operation room logbooks and individual patient medical records. The collected data were checked for consistency, coded, and entered into SPSS version 20 for data processing and analysis. Descriptive analysis was conducted, and tables and graphs and summary statistics were used to depict data. Results A total of 41 patients developed abdominal wound dehiscence from among 4137 patients who underwent abdominal laparotomy in the hospital. Among the patients, 51.2% were in the age range of 41 and above with mean age 29.8 (SD = 1.21) and 70.7% of them were male. Abdominal wound dehiscence was more common in emergency patients (90%) and vertical incision was the most common type of incision. Over half (58.5%) of the wound dehiscence occurred within 6–10 postoperative days. The majority (95.2%) of dehisced patients underwent relaparotomy for the management of the wound dehiscence, and 48.8% of them were treated with tension suture during the second operation of abdominal closure. Four of the patients (9.7%) died after the management of the second operation. Conclusion The current study revealed that the overall magnitude of abdominal wound dehiscence in the study area was 0.99%. Most of the dehiscence has occurred in male patients, and older age groups were highly affected than the younger ones. Emergency admission is the most common form of admission identified in the study, and this signifies appropriate preoperative preparation of patients for an optimal outcome. However, regarding the management outcome, 9.8% of patients died in our study within the institution after the second operation which is the high mortality rate.
Highlights
Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place
Study Area. e study was conducted at Saint Paul Hospital Millennium Medical College (SPHMMC), a tertiary teaching hospital, which is located in the Northern part of Addis Ababa, capital of Ethiopia
Concerning the management outcome of the second surgery, the current study showed that 9.8% of patients died within the institution after the second operation, which is lower than the studies conducted in Mesologgi General Hospital 20% [7], 45% in Pakistan [11], and 39.3% in Wiad Lek [6]. e reason might be due to the different sample sizes and the difference in the sociodemographic characteristics of the patients
Summary
Abdominal wound dehiscence (AWD) is a terminology that is commonly used to explain the separation of different layers of an abdominal wound before complete healing has taken place. Other terms used are acute laparotomy wound failure and burst abdomen [1]. Abdominal wound dehiscence is one of the most dreaded life-threatening complications owing to the associated rapid onset of often irreversible pathological sequel. It is a major cause of postoperative morbidity and mortality in Surgery Research and Practice sub-Saharan Africa including Ethiopia [4,5,6]. Patients undergoing emergency surgery are more at risk to develop abdominal wound dehiscence as compared to the patient undergoing elective surgery [16], and different studies have shown that its incidence is common in older age groups [17,18,19,20,21]. Is study is aimed to assess the magnitude of abdominal wound dehiscence and to describe patient and clinical factors associated with it in the study area
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