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.

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 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 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.

scholarly journals Study of risk factors of acute respiratory infections in children admitted in a tertiary care hospital of Southern Maharashtra

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Alka C. Kaware ◽  
Nitin H. Kamble ◽  
S. K. Mangulikar
Keyword(s):  
Risk Factors ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
High Morbidity ◽  
Acute Respiratory Infections ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of ◽  
Tract Infections

Background: Acute respiratory infections (ARI) is an important cause of mortality and morbidity in children. In India, it constitutes 15% of under five deaths. Various risk factors are responsible for ARI in children. Study of risk factors will help to reduce the high morbidity and mortality due to ARI. The objectives were to study risk factors responsible for acute respiratory infections in children and to find out case fatality rate &/ outcome of acute respiratory infections ARI in children.Methods: A hospital based cross sectional study was done in 2013-14 in a tertiary care centre to study the risk factors associated with ARI in children. All the pediatric patients between 0-12 years admitted in a tertiary care centre at Solapur were enrolled in the study.Results: Acute respiratory tract infections (ARI) were more common in 1-4 years age group i.e. 57.31% (196). It was more common in males i.e. 64.33% (220) than females i.e. 35.67% (122). ARI was more common in lower socio-economic classes i.e. class V (50.58%), class IV (22.52%); in patients whose mothers were illiterate 43.28% and who had history of parental smoking 84.21%. Maximum patients of ARI were having history of overcrowding 75.73%, inadequate cross-ventilation 81.87% and use of smoky chullah 78.65% in their home. Statistically significant association found between ARI cases and these socio-demographic factors. 46.78% (160) were incompletely immunized and 16.37% (56) were not immunized at all. Only 36.84% (126) were completely immunized for their age. Maximum cases of ARI (50.88%) occurred in winter season followed by rainy season (26.90%). Outcome showed that 91.52% (313) were cured, while 1.75% (6) patients died due to ARI.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ARI which can be prevented by effective health education and an appropriate initiative taken by the government.

scholarly journals Analysis of enteric ileal perforation: a prospective study in a tertiary care hospital

2017 ◽  
Vol 4 (3) ◽  
pp. 899
Author(s):  
Prabu Shankar S. ◽  
Sudarshan P.B. ◽  
Sundaravadanan B.S.
Keyword(s):  
Prospective Study ◽  
Tertiary Care ◽  
Wound Dehiscence ◽  
Fecal Fistula ◽  
High Morbidity ◽  
Care Hospital ◽  
Female Ratio ◽  
Ileal Perforation ◽  
Delay In Diagnosis ◽  
A Prospective Study

Background: Intestinal perforation as a complication of enteric fever is still a serious problem in developing nations. Enteric ileal perforation is associated with high morbidity and mortality and many patients present in a severe toxic state because of delay in diagnosis and late presentation to hospital.Methods: A prospective study was conducted to assess the prognostic factors in enteric ileal perforation. Observations were made regarding symptoms, signs, duration of illness and presentation of patients to the hospital after acute episode. Per operative findings regarding site, size and number of perforations were recorded. Operative procedures were simple closure, ileostomy, or resection of diseased segment including right hemicolectomy done for associated caecal perforation and entero enteric anastomosis. Post-operative complications like wound infection, wound dehiscence, residual abscess, faecal fistula and deaths were documented.Results: There were 50 enteric ileal perforation cases with a age range of 13-80 with a mean age of 30.7. Male: female ratio was 11: 1. 85% of patients presented within 48 hrs of onset of symptoms of perforation and there is significant mortality in patients who presented more than 48 hrs of onset of symptoms of perforation (57.14%). Mortality was high in multiple perforation group (40%) and also higher incidences of fecal fistula and wound dehiscence.Conclusions: Age and sex have no bearing on the outcome. Perforation presentation interval, delay in surgery, number of perforations are important prognostic markers for typhoid ileal perforation. 

scholarly journals Clinicoepidemiological study of acute invasive fungal rhinosinusitis in a tertiary care centre

2021 ◽  
Vol 7 (11) ◽  
pp. 1772
Author(s):  
Rajeshree Chaurpagar ◽  
Priyanka Garud ◽  
Apurva Pawde ◽  
Parag Doifode ◽  
Bhagyashree Chiplunkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
World Health ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
History Of ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>

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