Abdominal Wound Dehiscence in Emergency Laparatomy

Yadav PK

Abstract


Introduction: Abdominal wound dehiscence is a very stressful situation for the patient as well as the surgical team. This study was carried out to identify risk factors for wound dehiscence after emergency laparotomy, also to reduce hospital stay, psychosocial embarrassment , cost of treatment and mortality and morbidity resulting from wound dehiscence.

Method: A prospective observational study was conducted over 60 consecutive patients undergoing emergency laparotomy. The rate of wound dehiscence, patient factors (like jaundice, malnutrition, COPD, diabetes) and postoperative factors (like wound infection, vomiting or cough) were noted, analyzed and reviewed with relevant literature.

Result: The mean age of our patients was 39.8 years (range 15 – 72). Male to female ratio was 3.29. Most wound dehiscence occurred in the age group 41-50 yrs. The overall rate of wound dehiscence was 10 %. Those patients who had cough or wound infection in the early postoperative period had statistically significant risk for wound dehiscence Those patients who had the risk factors like COPD, anemia or smoking had increased chances for wound dehiscence as compared to those without, P value = 0.005.

Conclusion: Overall rate of wound dehiscence was 10%. Rates of wound dehiscence had no relation to age and sex of the patient or to the site of pathology. The rates of wound dehiscence increased significantly as the operative time increased. Patients with cough or wound infection in the early post-operative period had statistically significant increased risk for wound dehiscence. Patients with COPD, anemia or smoking history had increased chances of wound dehiscence

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