STUDY OF RISK FACTORS IN ABDOMINAL WOUND DEHISCENCE FOLLOWING EMERGENCY LAPAROTOMY

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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Risk Factors for Abdominal Wound Dehiscence in Neonates: A Retrospective Cohort Study

10.21203/rs.3.rs-117528/v1 ◽

2020 ◽

Author(s):

Shouxing Duan ◽

Xuan Zhang ◽

Xuewu Jiang ◽

Wenhui Ou ◽

Maxian Fu ◽

...

Keyword(s):

Risk Factors ◽

Survival Rates ◽

Operation Time ◽

Major Complication ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Preoperative Anemia ◽

Free Survival ◽

Moderate Anemia ◽

Abdominal Wound Dehiscence

Abstract Background: Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD.Methods: The clinical data for 453 cases of neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were found. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD.Results: The incidence of neonatal AWD was 6.0% (27/453), of which partial wound dehiscence 4.9% (22/453) and complete wound dehiscence 1.1% (5/453). Anemia, hypoproteinemia, and wound contamination were the main risk factors for neonatal AWD. The AWD-free survival rates for infants with severe anemia and mild to moderate anemia were 83.3% and 91.2%, respectively. The AWD-free survival rates for those with hypoproteinemia, type II and type III incision were 88.0%, 95.1% and 87.1%, respectively.Conclusion: Neonatal AWD is closely related to anemia, hypoproteinemia, and incision contamination. It is of great significance for the prevention of neonatal AWD to strengthen nutritional support, correct preoperative anemia, and control infection.Trial registration: Research Registry, researchregistry5350. Registered 01 February 2020 - Retrospectively registered, https://www.researchregistry.com/browse-the-registry#home/registrationdetails/5e359028eef79c001577fa18/

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A prospective study of risk factors for abdominal wound dehiscence

International Surgery Journal ◽

10.18203/2349-2902.isj20163983 ◽

2017 ◽

Author(s):

Rajesh Mahey ◽

Smruti Ghetla ◽

Jitesh Rajpurohit ◽

Dhaval Desai ◽

Sachin Suryawanshi

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence ◽

A Prospective Study

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Study of Risk Factors and Management of Abdominal Wound Dehiscence

International Journal of Contemporary Medicine Surgery and Radiology ◽

10.21276/ijcmsr.2018.3.4.3 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Vinay Sagar Cheeti ◽

D Asha ◽

B Raju

Keyword(s):

Risk Factors ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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

International Surgery Journal ◽

10.18203/2349-2902.isj20170986 ◽

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.

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Study of risk factors in post-laparotomy wound dehiscence

International Surgery Journal ◽

10.18203/2349-2902.isj20182764 ◽

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.

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Evaluation of Potential Risk Factors Causing Abdominal Wound Dehiscence

Academia Journal of Surgery ◽

10.47008/ajs/2020.3.1.5 ◽

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.

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