Study of Risk Factors in Patients with Post Lapartomy Wound Dehisence
Main Article Content
Abstract
Background: Post-laparotomy wound dehiscence is a significant complication in abdominal surgeries, characterized by the partial or complete separation of the surgical wound layers. This complication can lead to severe morbidity, extended hospital stays, and increased healthcare costs.
Objective: To assess the risk factors associated with wound dehiscence in patients post-laparotomy.
Methods: A cross-sectional study was conducted at the Department of Surgery from January 25, 2024, to April 25, 2024. A total of eighty patients who developed wound dehiscence following emergency or elective laparotomy were selected. Patient demographics, comorbid conditions, and clinical variables were recorded. The risk factors for wound dehiscence, including peritonitis, infection, malignancy, hypoproteinemia, and anemia, were assessed. Statistical analysis was performed using SPSS version 25, with Chi-square tests employed to assess associations between risk factors and comorbid conditions. A significance level of P ≤ 0.05 was considered statistically significant. Ethical approval was obtained, and the study adhered to the Declaration of Helsinki principles.
Results: The mean age of patients was 42.67 ± 15.26 years. Males had a higher frequency of wound dehiscence compared to females. The identified risk factors included wound infection (47; 58.8%), malignancy (37; 46.2%), hypoproteinemia (35; 43.8%), anemia (30; 37.5%), and peritonitis (22; 27.5%). A significant association was found between hypertension and the risk factors of wound infection (P=0.01), malignancy (P=0.002), and hypoproteinemia (P=0.01).
Conclusion: The study concluded that wound infection, malignancy, hypoproteinemia, anemia, and peritonitis are significant risk factors for wound dehiscence post-laparotomy. Hypertension showed a notable association with wound infection, hypoproteinemia, and malignancy. These findings underscore the importance of preoperative assessment and management of these risk factors to minimize the incidence of wound dehiscence.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Amilia OG, Komar H. Description of Post-Laparotomy Patients with Wound Dehiscence From 1st January 2019–31th December 2019 at Dr. Mohammad Hoesin General Hospital. J Surg. 2021;4(1):245-52.
Shanmugam VK, Fernandez SJ, Evans KK, McNish S, Banerjee AN, Couch KS, Mete M, Shara N. Postoperative Wound Dehiscence: Predictors and Associations. Wound Repair Regen. 2015;23(2):184-90.
Meyer CP, Rios Diaz AJ, Dalela D, Hanske J, Pucheril D, Schmid M, et al. Wound Dehiscence in a Sample of 1,776 Cystectomies: Identification of Predictors and Implications for Outcomes. BJU Int. 2016;117(6):95-101.
Preethi SP. The Evaluation of Risk Factors in Abdominal Wound Dehiscence. Int J Surg. 2019;3(4):78-81.
Cheeti VS, Asha D, Raju B. Study of Risk Factors and Management of Abdominal Wound Dehiscence. Emergency. 2018;60:77-4.
Mahey R, Ghetla S, Rajpurohit J, Desai D, Suryawanshi S. A Prospective Study of Risk Factors for Abdominal Wound Dehiscence. Int Surg J. 2017;4(1):24-8.
Denys A, Monbailliu T, Allaeys M, Berrevoet F, van Ramshorst GH. Management of Abdominal Wound Dehiscence: Update of the Literature and Meta-Analysis. Hernia. 2021;25(5):449-62.
Hassan D. Wound Infections and Dehiscence. Surgery. 2020.
Sandy-Hodgetts K, Carville K, Leslie GD. Surgical Wound Dehiscence: A Conceptual Framework for Patient Assessment. J Wound Care. 2018;27(3):119-26.
Sandy-Hodgetts K, Ousey K, Howse E. Top Ten Tips: Management of Surgical Wound Dehiscence. Wounds Int. 2017;8(1):11-5.
Heller L, Levin SL, Butler CE. Management of Abdominal Wound Dehiscence Using Vacuum Assisted Closure in Patients with Compromised Healing. Am J Surg. 2006;191(2):165-72.
Webster C, Neumayer L, Smout R, Horn S, Daley J, Henderson W, et al. Prognostic Models of Abdominal Wound Dehiscence After Laparotomy. J Surg Res. 2003;109(2):130-7.
Rodríguez-Hermosa JI, Codina-Cazador A, Ruiz B, Roig J, Gironès J, Pujadas M, et al. Risk Factors for Acute Abdominal Wall Dehiscence After Laparotomy in Adults. Cir Esp. 2005;77(5):280-6.
Hahler B. Surgical Wound Dehiscence. Medsurg Nurs. 2006;15(5):296.
Spiliotis J, Tsiveriotis K, Datsis AD, Vaxevanidou A, Zacharis G, Giafis K, et al. Wound Dehiscence: Is Still a Problem in the 21st Century: A Retrospective Study. World J Emerg Surg. 2009;4:12.
Carlson MA. Acute Wound Failure. Surg Clin North Am. 1997;77(3):607-36.
van Ramshorst GH, Nieuwenhuizen J, Hop WC, Arends P, Boom J, Jeekel J, et al. Abdominal Wound Dehiscence in Adults: Development and Validation of a Risk Model. World J Surg. 2010;34(1):20-7.
Verma S, Patil SM, Bhardwaj A. Study of Risk Factors in Post-Laparotomy Wound Dehiscence. Int Surg J. 2018;5(7):2513-7.
Gillespie BM, Harbeck EL, Sandy-Hodgetts K, Rattray M, Thalib L, Patel B, Andersson AE, Walker RM, Latimer S, Chaboyer WP. Incidence of wound dehiscence in patients undergoing laparoscopy or laparotomy: a systematic review and meta-analysis. Journal of wound care. 2023 Aug 1;32(Sup8a):S31-43.
Aksamija G, Mulabdic A, Rasic I, Aksamija L. Evaluation of Risk Factors of Surgical Wound Dehiscence in Adults After Laparotomy. Med Arch. 2016;70(5):369-72.