Magnitude of Abdominal Wound Dehiscence and Associated Factors of Patients Who Underwent Abdominal Operation at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Background. Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place. It is a major cause of postoperative morbidity and mortality in sub-Saharan Africa including Ethiopia, and little is known about its prevalence and related factors in the study area. Objectives. The aim of this study is to assess the magnitude of abdominal wound dehiscence and related factors on patients operated at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods. A hospital-based retrospective review of the chart was carried out by using the data covering three years (September 2014–September 2017) period. Data were collected from hospital medical records of sampled patients such as operation room logbooks and individual patient medical records. The collected data were checked for consistency, coded, and entered into SPSS version 20 for data processing and analysis. Descriptive analysis was conducted, and tables and graphs and summary statistics were used to depict data. Results. A total of 41 patients developed abdominal wound dehiscence from among 4137 patients who underwent abdominal laparotomy in the hospital. Among the patients, 51.2% were in the age range of 41 and above with mean age 29.8 (SD = 1.21) and 70.7% of them were male. Abdominal wound dehiscence was more common in emergency patients (90%) and vertical incision was the most common type of incision. Over half (58.5%) of the wound dehiscence occurred within 6–10 postoperative days. The majority (95.2%) of dehisced patients underwent relaparotomy for the management of the wound dehiscence, and 48.8% of them were treated with tension suture during the second operation of abdominal closure. Four of the patients (9.7%) died after the management of the second operation. Conclusion. The current study revealed that the overall magnitude of abdominal wound dehiscence in the study area was 0.99%. Most of the dehiscence has occurred in male patients, and older age groups were highly affected than the younger ones. Emergency admission is the most common form of admission identified in the study, and this signifies appropriate preoperative preparation of patients for an optimal outcome. However, regarding the management outcome, 9.8% of patients died in our study within the institution after the second operation which is the high mortality rate.

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A clinical study of abdominal wound dehiscence with emphasis on surgical management in Bangalore medical college and research institute, Karnataka, India

International Surgery Journal ◽

10.18203/2349-2902.isj20164078 ◽

2017 ◽

Cited By ~ 1

Author(s):

Ketan Kapoor ◽

Mir Hassan

Keyword(s):

Clinical Study ◽

Surgical Management ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Medical College ◽

Abdominal Wound Dehiscence ◽

Research Institute

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Comparative study of abdominal wound dehiscence in continuous versus interrupted fascial closure after emergency midline laparotomy

International Surgery Journal ◽

10.18203/2349-2902.isj20190819 ◽

2019 ◽

Vol 6 (3) ◽

pp. 886

Author(s):

Rajesh Kumar Bansiwal ◽

Tarun Mittal ◽

Rajeev Sharma ◽

Sanjay Gupta ◽

Simrandeep Singh ◽

...

Keyword(s):

Rectus Sheath ◽

Wound Dehiscence ◽

Fascial Closure ◽

Emergency Laparotomy ◽

Abdominal Wound ◽

Midline Laparotomy ◽

Medical College ◽

Group A ◽

Abdominal Wound Dehiscence ◽

Group B

Background: Laparotomy wound dehiscence is still a puzzle for most of the surgeons. Mortality associated with dehiscence has been estimated at 10-30%. Patients undergoing emergency laparotomy suffer from one of these comorbid conditions which are detrimental to healing. In this scenario interrupted suturing has been found to give good strength and have less incidence of wound dehiscence. The objective of the study was to compare the incidence of abdominal wound dehiscence in emergency midline laparotomy.Methods: This study was conducted on 300 consecutive patients undergoing emergency midline laparotomy in the Department of Surgery, Government Medical College and Hospital. Methods group-A: closed by suturing the rectus sheath using polydioxanone suture 1-0 (PDS) in continuous layer suturing method. group-B: closed by suturing the rectus sheath using polydioxanone suture 1-0 in interrupted layer suturing method.Results: The mean age in group A was 40.47 years and 37.47 in group B. In Group A 20.1% patients had burst abdomen and 5.4% in group B.Conclusions: Interrupted closure of abdominal wall fascia is better in emergency laparotomy as compared to continuous closure.

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ABDOMINAL WOUND DEHISCENCE

Australian and New Zealand Journal of Surgery ◽

10.1111/ans.1990.60.3.153 ◽

1990 ◽

Vol 60 (3) ◽

pp. 153-155 ◽

Cited By ~ 5

Author(s):

THOMAS B. HUGH

Keyword(s):

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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Operations for Necrotizing Infections of Abdominal Wall and Infected Abdominal Wound Dehiscence

Operative Strategy in General Surgery ◽

10.1007/978-1-4757-4169-8_86 ◽

1994 ◽

pp. 727-730

Author(s):

Jameson L. Chassin

Keyword(s):

Abdominal Wall ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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Erratum to "Vacuum drainage in the management of complicated abdominal wound dehiscence"

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2009.11.005 ◽

2009 ◽

Vol 44 (12) ◽

pp. 2440

Keyword(s):

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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Operations for Infected Abdominal Wound Dehiscence and Necrotizing Soft Tissue Infection of the Abdominal Wall

Operative Dictations in General and Vascular Surgery ◽

10.1007/978-1-4614-0451-4_104 ◽

2011 ◽

pp. 504-507

Author(s):

Kristen C. Sihler

Keyword(s):

Soft Tissue ◽

Abdominal Wall ◽

Soft Tissue Infection ◽

Wound Dehiscence ◽

Tissue Infection ◽

Abdominal Wound ◽

Necrotizing Soft Tissue Infection ◽

Abdominal Wound Dehiscence

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Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

South Sudan Medical Journal ◽

10.4314/ssmj.v14i3.4 ◽

2021 ◽

Vol 14 (3) ◽

pp. 85-88

Author(s):

Jok Thikuiy Gang ◽

Sisay Kirba Kea ◽

Samson Gebremedhin

Keyword(s):

Ectopic Pregnancy ◽

Medical Records ◽

Selection Criteria ◽

Surgical Intervention ◽

Addis Ababa ◽

Safe Alternative ◽

Medical College ◽

Endometrial Cavity ◽

Emergency Surgical Intervention ◽

Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

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Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.4.3671 ◽

2021 ◽

Vol 37 (4) ◽

Author(s):

Ahmed Siddique Ammar ◽

Syed Asghar Naqi ◽

Shehrbano Khattak ◽

Ahmed Raza Noumani

Keyword(s):

Sampling Technique ◽

Wound Dehiscence ◽

P Value ◽

Emergency Laparotomy ◽

Abdominal Wound ◽

Creative Commons ◽

Surgical Ward ◽

Group A ◽

Abdominal Wound Dehiscence ◽

Group B

Objective: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure. Methods: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared. Results: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063). Conclusion: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn’t help in healing of wound and reclosure of the dehisced abdominal wound is needed. doi: https://doi.org/10.12669/pjms.37.4.3671 How to cite this:Ammar AS, Naqi SA, Khattak S, Noumani AR. Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure. Pak J Med Sci. 2021;37(4):1118-1121. doi: https://doi.org/10.12669/pjms.37.4.3671 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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