Risk Factors of Wound Dehiscence in Abdominal Surgery

Abstract

Background: Wound dehiscence, a significant postoperative complication characterized by the partial or complete separation of a surgical wound, remains a challenge despite advances in surgical techniques and perioperative care. It is associated with increased morbidity, mortality, prolonged hospital stays, and higher healthcare costs. Understanding the risk factors that predispose patients to wound dehiscence is crucial for improving surgical outcomes. Objective: The aim of this study was to identify the patient-related and surgical factors that contribute to the risk of wound dehiscence in individuals undergoing abdominal surgery, in order to inform strategies for risk reduction and management. Methods: This prospective cohort study was conducted at the General Surgery Department of Hayatabad Medical Complex, Peshawar, Pakistan, from January 2021 to January 2023. A total of 150 patients who underwent elective or emergency abdominal surgery were included. Exclusion criteria encompassed individuals undergoing obstetric or gynecological procedures and those with a prior history of wound infection or dehiscence. Data on demographic characteristics, comorbidities, type of surgery, surgical approach, and postoperative outcomes were collected. Wound dehiscence was the primary outcome, identified clinically and confirmed by surgical review. Statistical analysis involved descriptive statistics, bivariate analyses using chi-square tests, with significance set at p ≤ 0.05. Results: The mean age of the study population was 45.6 ± 12.3 years, with 60% male and 40% female participants. Comorbidities included obesity (30%), diabetes mellitus (23.3%), hypertension (16.7%), cardiovascular disease (13.3%), and smoking (20%). Elective surgeries constituted 66.7% of cases, with gastrointestinal disorders being the most common indication (46.7%). The open surgical approach was utilized in 80% of procedures. Wound dehiscence occurred in 23.4% of patients with obesity, 18.2% with diabetes mellitus, 15.6% who were smokers, 13% with hypertension, and 18.2% of advanced age. Conclusion: The study highlights obesity, diabetes mellitus, smoking, hypertension, and advanced age as significant risk factors for wound dehiscence following abdominal surgery. Addressing these modifiable factors through tailored preoperative assessment and postoperative care is essential for reducing the incidence of wound dehiscence.