Abdominal wound dehiscence: frequency and risk factors

ABSTRACT

To determine the frequency and associated risk factors in patients with abdominal wound dehiscence. A descriptive study. Surgical Unit-I, Chandka Medical College Teaching Hospital, Larkana, between May 2002 toApril 2005. This study included patients with various etiologies of emergency and elective midline laparotomies. The patients operated with other incisionswere excluded. The data obtained was analyzed for each patient and postoperative complications were documented. Out of total 300 patients, 16 developed wound dehiscence giving an overall frequency of5.33%. Age ranged from 10-82 years with mean age of 33.5. Male to female ratio was 10.58. The frequency was greater in males than females with ratio 31. Majority of the patients had gut perforation with peritonitis. Out of twenty one patients with hypoalbuminemia, 09 develops wound dehiscence. Emergency surgery showed a higher frequency of wound dehiscence 7% [14/200] compared to elective surgery 2% [2/100]. Wound infection was a major factor to wound failure. Old age was also associated with greater frequency. The mortality rate of abdominal wound dehiscence was 25%, due to septicemia and multiple organfailure.Abdominal wound dehiscence still continues to be a major postoperative complication, with a high morbidity and mortality, and has significant impact on health care cost. The significant risk factors in this study were primary disease presented with peritonitis, emergency surgery, old age, male gender; wound injection and technique of closure. Less significant factors were jaundice, uremia, diabetes, and type of suture material used