A PROSPECTIVE STUDY OF PREDICTORS FOR POST LAPAROTOMY 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.

Successful Management of Abdominal Wound Dehiscence with Bogota bag, Vacuum assisted Closure combined with Tension Sutures

The burst abdomen management has advanced significantly. Here we present a management of a burst abdomen of morbid obese patient with combination of modality including Bogota bag, vacuum assisted closure and tension suturing. The patient underwent laparotomy for removal of sigmoid tumor with local infiltration and had wound dehiscence associated with infection, tissue oedema and necrosis. As patient was morbidly obese and had large wound gap, we decided to manage it with Bogota bag principal and Vacuum Assisted Closing. After successful formation of granulation tissue, we were able to apply tension sutures. Hence using combination of above-mentioned options, the patient was successfully sent back to his normal routines without any complication.

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>

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

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.

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

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/