Evaluation of Effects of Various Co-Morbidities on Abdominal Wound Dehiscence after Midline Laparotomy
Authors/Creators
- 1. Assistant Professor, Department of General Surgery, Terna Medical College Nerul, Navi Mumbai, Maharashtra 400706
Description
Background: Abdominal wound dehiscence (AWD) is a terminology which is commonly used to explain separation of different layers of an abdominal wound before complete healing has taken place. Other terms used interchangeably are acute laparotomy wound failure and burst abdomen. Wound dehiscence usually occurs when a wound fails to achieve required strength to withstand stresses placed upon it. Postoperative wound healing plays a significant role in facilitating a patient’s recovery and rehabilitation. Surgical wound dehiscence (SWD) impacts on mortality and morbidity rates and significantly contributes to prolonged hospital stays and associated psychosocial stressors on individuals and their families. Materials and Methods: This is a prospective study conducted in the Tertiary care teaching Hospital. Patients who had undergone abdominal surgery (laparotomy) who developed acute fascial wound dehiscence (AFWD) and who had to return to the operating theatre for closure of the fascial dehiscence under general anaesthesia. The medical records were reviewed and the diagnosis of fascial dehiscence was confirmed for all included patients. Each single case was matched to two cases of patients who were admitted in the same year for surgery and who underwent similar surgical intervention, were of the same gender, and were within 5 years of the index patients’ age. Patients who developed incisional hernia on follow-up were excluded due to the aetiological overlap between fascial dehiscence and incisional hernia. Result: Out of these 90 cases 43 patients were female (47.8%) and 47 patients were male (52.2%). The cases were distributed in two groups randomly depending on the technique of midline closure. Out of the total 90 patients, 20 (22.2%) had band obstruction, 15 (16.7%) had sigmoid volvulus 13 (14.4%) had gastric carcinoma, 10 (11.1%) had sigmoid cancer, 1 (1.1%) had mid gut volvulus, 13 (14.4%) had obstructed hernia, 8 (8.9%) had carcinoma of ascending colon, 10 (11.1%) had pyloric stenosis. The other co morbidities which contributed to wound dehiscence were DM, HTN, Pulmonary Disease, Malnutrition and Anaemia. Out of everything DM had a Significant amount of contribution. Conclusion: We therefore hope that the results of this study will lead to better, evidence-based treatment options for abdominal wound dehiscence and, eventually, a lower incidence of this severe complication.
Abstract (English)
Background: Abdominal wound dehiscence (AWD) is a terminology which is commonly used to explain separation of different layers of an abdominal wound before complete healing has taken place. Other terms used interchangeably are acute laparotomy wound failure and burst abdomen. Wound dehiscence usually occurs when a wound fails to achieve required strength to withstand stresses placed upon it. Postoperative wound healing plays a significant role in facilitating a patient’s recovery and rehabilitation. Surgical wound dehiscence (SWD) impacts on mortality and morbidity rates and significantly contributes to prolonged hospital stays and associated psychosocial stressors on individuals and their families. Materials and Methods: This is a prospective study conducted in the Tertiary care teaching Hospital. Patients who had undergone abdominal surgery (laparotomy) who developed acute fascial wound dehiscence (AFWD) and who had to return to the operating theatre for closure of the fascial dehiscence under general anaesthesia. The medical records were reviewed and the diagnosis of fascial dehiscence was confirmed for all included patients. Each single case was matched to two cases of patients who were admitted in the same year for surgery and who underwent similar surgical intervention, were of the same gender, and were within 5 years of the index patients’ age. Patients who developed incisional hernia on follow-up were excluded due to the aetiological overlap between fascial dehiscence and incisional hernia. Result: Out of these 90 cases 43 patients were female (47.8%) and 47 patients were male (52.2%). The cases were distributed in two groups randomly depending on the technique of midline closure. Out of the total 90 patients, 20 (22.2%) had band obstruction, 15 (16.7%) had sigmoid volvulus 13 (14.4%) had gastric carcinoma, 10 (11.1%) had sigmoid cancer, 1 (1.1%) had mid gut volvulus, 13 (14.4%) had obstructed hernia, 8 (8.9%) had carcinoma of ascending colon, 10 (11.1%) had pyloric stenosis. The other co morbidities which contributed to wound dehiscence were DM, HTN, Pulmonary Disease, Malnutrition and Anaemia. Out of everything DM had a Significant amount of contribution. Conclusion: We therefore hope that the results of this study will lead to better, evidence-based treatment options for abdominal wound dehiscence and, eventually, a lower incidence of this severe complication.
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IJPCR,Vol15,Issue10,Article67.pdf
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Additional details
Dates
- Accepted
-
2023-09-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue10,Article67.pdf
- Development Status
- Active
References
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