[Factors influencing wound dehiscence in abdominal operation]

ABSTRACT

The purpose of this study was to review our clinical experience with abdominal wound dehiscence. During the 5-year period from [1997-2001], there were 2.761 major abdominal operations performed at the Department of Surgery Imam Reza Hospital. Mashhad, Iran. Twenty-one specific local and systemic risk factors were analyzed and compared with the control group. 31 [1%] abdominal wound dehiscence's occurred in 2.76 1 patients undergoing major abdominal surgery. Significant risk factors were found to include age over 65 year, wound infection, pulmonary disease, helnodynamic instability and ostomies through incision. Risk factors not found to be important included, sex, type of incision, type of closure, anemia-jaundice and diabetes. When dehiscence and control groups were combined 30% of patients with at least five significant risk factor developed dehiscence, and all the patients with more than eight risk factors developed a wound dehiscence.There was an overall mortality of 29% which was directly related to the number of significant risk factors. The coexistence of 9 risk factors portended death in one third of the patients, and all the patients with more than 10 risk factor died. Wound dehiscence carries a very high mortality rate and major morbidity. It is a dreaded complication that increases hospital stay and cost. We believe that serious consideration should be given to placing retention sutures in high risk patients to try to prevent evisceration and dehiscence. Serous drainage from a wound after surgery should alert the physician to possible wound dehiscence