P-079 INCIDENCE AND RISK FACTORS OF ABDOMINAL FASCIAL DEHISCENCE AFTER EXPLORATORY LAPAROTOMY- AN AUDIT OF 282 CASES

Abstract

Abstract Background An audit was performed to identify the incidence and risk factors of post-operative abdominal fascial dehiscence after Exploratory laparotomy. Methods The prospectively maintained database of a single unit was reviewed.The demographic parameters, comorbidities, degree of contamination, type of procedures, and the types of suture & needles were reviewed.We analyzed the relation of the type of sutures, type of surgery and degree of contamination on the development abdominal fascial dehiscence within 30 days of surgery .Difference between the groups were analyzed by t tests for continuous variables and Chi squared tests for categorical variables. Results 50 (17.7%) patients developed fascial dehiscence.Mean Albumin was 2.45 +/- 0.69 g/dl in the dehiscence group, compared to 2.97 +/- 0.86 g/dl in those without dehiscence (p= 0.00).The prevalence of diabetics, smokers and incidence of postoperative surgical site infection were significantly more in the patients with dehiscence (p value - 0.045, 0.043 and 0.00 respectively).Prevalence of class 4 wounds was higher in the group with dehiscence (70% vs 44%, p value 0.001).Type of suture used (Loop PDS No. 1 vs PDS 2–0) did not significantly influence development of facial dehiscence within 1 month. Conclusion Results of our study are consistent with existing literature. Important preoperative/intraoperative parameters such as smokingr, diabetics, preoperative hypovolemic shock, albumin are significant predictors of fascial dehiscence in the post operative period. This will enable surgeons to take corrective measures before the surgery