Frequency and risk factor of abdominal wound dehiscence

ABSTRACT

To find out the frequency of abdominal wound dehiscence [AWD] in a tertiary care hospital and the assessment of associated risk factors. Design: a cross sectional analytical study. Place and Duration of Study This study was carried out at Nishter Hospital Multan between May 1998 to May 2000. Subjects and This study was carried out on 406 patients who underwent laparotomy for intra peritoneal procedure and complied with inclusion criteria. Demographic features were recorded and any complications documented. Out of a total of 406 patients, 32 showed wound dehiscence giving an over all frequency of 7.8%. The male to female ratio was 2.81. The frequency was greater in males than in females. Majority patients suffered from an underlying malignancy. Malignant intestinal obstruction was the leading cause of wound dehiscence. Forty three patients had hypo-albuminemia[serum albumin <35 gm/l] and 09 of them had AWD. Emergency surgery showed a higher frequency of AWD[12.5%], as compared to elective surgery [18/143 and 14/263 respectively]. Wound infection was a major contributor to AWD as out of 406, 76 patients developed infection and then 21 manifested AWD. older age was also associated with greater frequency. The overall mortality of AWD in this study was 28.1%. AWD still continues to be major post operative complication, with a high morbidity and mortality. The significant risk factors in this study were age more than 55 years, male gender, underlying malignancy, wound infection, jaundice, use of steroids, emergency surgery, uraemia and technique of closure