scholarly journals KIMS 14: a new scoring system to predict abdominal wound dehiscence following emergency laparotomy

2017 ◽  
Vol 4 (4) ◽  
pp. 1230
Author(s):  
Akshay V. Gokak ◽  
Ramesh H. ◽  
Abhijit D. H. ◽  
Vasant T.
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Significant Risk ◽  
Wound Dehiscence ◽  
Emergency Laparotomy ◽  
Abdominal Wound ◽  
Duration Of Symptoms ◽  
Midline Laparotomy ◽  
Duration Of Surgery ◽  
Abdominal Wound Dehiscence

Background: Abdominal wound dehiscence is a common complication of emergency laparotomy in Indian setup. Wound dehiscence carries with it a substantial morbidity and mortality. Hence, we have developed a scoring system which can predict wound dehiscence following emergency laparotomy and prophylytic measures can be taken preoperatively to prevent this. Objectives were to identify independent risk factors for abdominal wound dehiscence and to develop a scoring system to recognize high risk patients.Methods: An observational, longitudinal, analytical and retrospective study was done from July 2014 to January 2017 in KIMS Hubli, Karnataka, India, where the sample studied were patients who underwent midline laparotomy during the study period. 30 cases of abdominal wound dehiscence were taken and 60 controls.Results: 30 cases of abdominal wound dehiscence following emergency laparotomy were reported and compared with 60 selected controls. Age, gender duration of symptoms hypotension, anemia hyperbilirubinemia, hypoproteinemia, uremia, duration of surgery, contaminated wounds, COPD/chest infections were statistically significant. Multivariate binary logistic regression showed Hypoproteinemia, uremia duration of surgery contaminated wounds and chest infection/COPD as independent significant risk factor and a scoring system was developed using these variables.Conclusions: The scoring system developed can identify the high-risk patients and necessary measures can be taken to prevent this complication.

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

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.

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

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.

scholarly journals Study of burst abdomen: it’s causes and management

2018 ◽  
Vol 5 (3) ◽  
pp. 1035 ◽  
Author(s):  
N. K. Jaiswal ◽  
Sandeep Shekhar
Keyword(s):  
Significant Risk ◽  
Wound Dehiscence ◽  
Clinical History ◽  
Duodenal Perforation ◽  
Abdominal Wound ◽  
Burst Abdomen ◽  
Impaired Wound Healing ◽  
Hospitalised Patients ◽  
Abdominal Wound Dehiscence ◽  
The Impact

Background: Burst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Burst abdomen is defined  as post-operative separation of abdominal musculo-aponeurotic layers.  The  study aims to find etiological factors of burst abdomen in hospitalised patients ,evaluate current management  methods and to compare conservative and operative approach with respect to complication and outcomes.Methods: All cases presenting with abdominal wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed , type of disease involved and management methods and their outcome. A total of 82 cases were included in this prospective study. Data was analysed using appropriate software.Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5th decade. Patients presenting with peritonitis secondary to gastro-duodenal perforation are more prone to burst abdomen.Conclusions: Burst abdomen is a serious sequel of impaired wound healing. Presence of anaemia,  hypoproteinemia favours high incidence of burst abdomen. Delayed suturing,  of burst abdomen has a lower frequency of complications . Adherence to proper technique and sincere efforts to minimize the impact of the predisposing factors play a much larger role in both treatment and prevention of this condition. 

scholarly journals Study of risk factors in post-laparotomy wound dehiscence

2018 ◽  
Vol 5 (7) ◽  
pp. 2513
Author(s):  
Siddharth Verma ◽  
Sagar Manohar Patil ◽  
Ankur Bhardwaj
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Wound Dehiscence ◽  
Clinical History ◽  
Duodenal Perforation ◽  
High Morbidity ◽  
Abdominal Wound ◽  
Mortality And Morbidity ◽  
Initial Surgery ◽  
Abdominal Wound Dehiscence

Background: Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. The need for this study is to highlight the risk factors for wound dehiscence and remedial measures to prevent or reduce the incidence of wound dehiscence. This will certainly reduce mortality and morbidity in the form of prolonged hospital stay, increased economic burden on health care resources.Methods: This is a prospective and observational study involving all those who have developed abdomen wound dehiscence after initial surgery, an elaborative study of these cases with regard to date of admission, clinical history regarding the mode of presentation, significant risk factors, investigations, time of surgery and type of surgery postoperatively, study of diagnosis and day of diagnosis of wound dehiscence is done till the patient is discharged from the hospital. The collected data is analysed and statistics were made according to need.Results: The incidence of abdominal wound dehiscence is more common in male patients in 4th to 5th decade. Patients with peritonitis due to duodenal perforation, complicated appendicitis, pyoperitoneum and intestinal obstruction and carried higher risk of abdominal wound dehiscence. Abdominal wound dehiscence was more common in patients operated in emergency. Patients with intra-abdominal infection, anaemia, hypoalbuminemia, jaundice had higher incidence of wound dehiscence.Conclusions: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions. 

scholarly journals Evaluation of Potential Risk Factors Causing Abdominal Wound Dehiscence

2020 ◽  
Vol 3 (1) ◽  
pp. 21-25
Author(s):  
Ajay Kumar Jha ◽  
Santosh Kumar ◽  
Ajit Kumar Sinha
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Wound Dehiscence ◽  
Clinical History ◽  
Duodenal Perforation ◽  
High Morbidity ◽  
Abdominal Wound ◽  
Initial Surgery ◽  
Abdominal Wound Dehiscence ◽  
Intra Abdominal Infection

Background: Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. The aim of this study was to highlight the risk factors for wound dehiscence and remedial measures to prevent or reduce the incidence of wound dehiscence. Subjects and Methods: This is a prospective and observational study involving all those who have developed abdomen wound dehiscence after initial surgery, an elaborative study of these cases with regard to date of admission, clinical history regarding the   mode of presentation, significant risk factors, investigations, time of surgery and type of surgery postoperatively, study of diagnosis and day   of diagnosis of wound dehiscence is done till the patient is discharged from the hospital. The collected data is analysed and statistics were  made according to need. Results: The incidence of abdominal wound dehiscence is more common in male patients in 4th to 5th decade. Patients with peritonitis due to duodenal perforation, complicated appendicitis, pyoperitoneum and intestinal obstruction carried higher risk of abdominal wound dehiscence. Abdominal wound dehiscence was more common in patients operated in emergency. Patients with intra-abdominal infection, anaemia, hypoalbuminaemia, jaundice had higher incidence of wound dehiscence. Conclusion: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions.

A PROSPECTIVE STUDY OF PREDICTORS FOR POST LAPAROTOMY ABDOMINAL WOUND DEHISCENCE

2021 ◽  
pp. 54-58
Author(s):  
Sajib Chatterjee ◽  
Basanta Banerjee ◽  
Asis Kumar Saha ◽  
Maitreyee Mukherjee ◽  
Saugata Samanta
Keyword(s):  
Tertiary Care ◽  
Wound Dehiscence ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Care Hospital ◽  
Abdominal Wound ◽  
Tertiary Care Centre ◽  
Antimicrobial Drugs ◽  
Contaminated Wound ◽  
Abdominal Wound Dehiscence

Introduction: Wound dehiscence or burst abdomen is a very serious post-operative complication which is associated with high morbidity and mortality rates. Despite the advances made in asepsis, antimicrobial drugs, sterilization and operative techniques- post-operative wound dehiscence continues to be a major threat. Aims And Objectives: 1. To nd the incidence of abdominal wound dehiscence following laparotomy in a tertiary care centre of Eastern India. 2. To evaluate the factors implicated and their contribution in abdominal wound dehiscence Methodology: This prospective single centre observational study was conducted at a tertiary care hospital on 100consenting patients undergoing both elective and emergency laparotomy..All the cases were followed up on postoperative days 1, 4, 7 and 10 or till discharge and further follow up was continued every 2 weeks till 4 weeks . Patients with wound dehiscence were evaluated by the investigators for the enlisted parameters which were ,age sex; BMI; comorbidities like anemia. hypoproteinemia; hypertension.jaundice,increased urea creatinine ,habit of smoking;presence of clean or contaminated wound and various other factors like time of surgery,use of steroids,ASA physical status and so on. Results: We found that wound dehiscence was signicantly more in male patients;patients with increased BMI,presence of anemia, hypoproteinemia, increased serum urea creatinine level. It was more in contaminated wound and patients with higher ASA physical status.But time taken for surgery type of surgery has no inuence on wound dehiscence in this study. Conclusion: Post laprotomy wound dehiscence depends on multiple factors.

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