Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice

<p>Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.</p>

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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 burst abdomen: it’s causes and management

International Surgery Journal ◽

10.18203/2349-2902.isj20180826 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1035 ◽

Cited By ~ 1

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.

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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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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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STUDY OF RISK FACTORS IN ABDOMINAL WOUND DEHISCENCE FOLLOWING EMERGENCY LAPAROTOMY

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2017/557 ◽

2017 ◽

Vol 4 (46) ◽

pp. 2811-2818

Author(s):

Anand Kumar Jaiswal ◽

Rakesh Saxena ◽

Krishna Mohan Kushwaha

Keyword(s):

Risk Factors ◽

Wound Dehiscence ◽

Emergency Laparotomy ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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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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Risk factors of abdominal wound dehiscence in abdominal surgery

Khirurgiya Zhurnal im N I Pirogova ◽

10.17116/hirurgia202010168 ◽

2020 ◽

pp. 68

Author(s):

V.A. Samartsev ◽

V.A. Gavrilov ◽

M.V. Kuznetsova ◽

M.P. Kuznetsova

Keyword(s):

Risk Factors ◽

Abdominal Surgery ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Abdominal Wound Dehiscence

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Competition Test Veteran Affairs Medical Centre (VAMC) Score and KIMS-14 for Predicting the Dehiscence of Abdoment Post Laparotomy Operating Wounds

Sriwijaya Journal of Surgery ◽

10.37275/sjs.v3i1.24 ◽

2020 ◽

Vol 3 (1) ◽

pp. 11-22

Author(s):

Reza Akmal ◽

Efman EU Manawan ◽

Mgs Irsan Saleh

Keyword(s):

Area Under Curve ◽

Wound Dehiscence ◽

Abdominal Wound ◽

Burst Abdomen ◽

Death Rates ◽

Digestive Surgery ◽

Veteran Affairs ◽

Test Study ◽

Abdominal Wound Dehiscence ◽

Significant Mortality

Introduction. Abdominal wound dehiscence (AWD) is a complication of severe postoperative abdominal surgery, with reported death rates ranging from 10% to 45%. Significant mortality, prolonged hospitalization, increased incidence of incisional hernias and reoperations for ruptured stomachs, with costs associated with the community, emphasize the severity of these complications. The VAMC score and KIMS-14 can be used as screening in predicting surgical injury dehiscence Method.This study is a diagnostic test study to assess the sensitivity and specificity of VAMC and KIMS-14 scoring in predicting the occurrence of abdominal wound dehiscence to be performed in surgery outpatient and digestive surgery ward at the General Hospital, Dr. Mohammad Hoesin Palembang in the period March to May 2019.Results. There were 44 subjects that participated in this study. VAMC has a sensitivity value of 87.5% and specificity of 97.2 with an area under curve value of 0.958 with a cut-off of  10. KIMS 14 has a sensitivity value of 100% and a specificity of 94.4% with an area under curve value of 0.944 with a cut-off of  5.Conclusion: KIMS-14 is better in sensitivity, but VAMC is more specific to predict dehiscence licensing in patients undergoing intraabdominal surgery.Keywords: VAMC, KIMS-14, abdominal wound dehiscence, post-laparotomy, mortality, burst abdomen.

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