Objective: To calculate the frequency of wound dehiscence after midline laparotomies; as well as look into the factors associated with the grave complication. Study Design: Cross Sectional Design. Setting: Department of Surgery, Ayub Teaching Hospital, Abbottabad. Period: 25-05-2019 to 24-11-2019. Material & Methods: Data including factors studied and diagnosis of abdominal wound dehiscence were noted on prepared pro forma. Patients were followed and final outcome was assessed. Results: Of these 134 cases, 94 (70.1 %) were male whereas 40 (29.9 %) were female. Mean age was 31.57 ± 11.38 years. Significant association of wound dehiscence with age (p=0.007), residential status (p=0.001), preoperative use of antibiotics (p=0.001), obesity (p=0.002), suture material used (p=0.011) and use of drain (p=0.001) was determined. Wound dehiscence was noted in 23 patients (17.2%). Conclusion: High frequency of wound dehiscence was observed in patients undergoing midline laparotomies during the study. Wound dehiscence was significantly associated with age, residential status, preoperative antibiotics usage, obesity, suture material preferences and drain placement. These complications must be anticipated for early diagnosis and proper management to decrease the burden of related morbidities and mortalities.
Objectives: To determine the frequency of obstructive appendicitis in patients undergoing open appendectomies for acute appendicitis. Negative appendectomy rate will also be calculated. Study Design: Cross-Sectional study. Setting: Department of General Surgery of Ayub Teaching Hospital Abbottabad. Period: September 2019 to February 2020. Material & Methods: The study population included patients of any gender, age from 10 years to 45 years found to have acute appendicitis diagnosed by clinical and ultrasound findings and confirmed by open appendectomy. Sample size of 174 was calculated, using WHO software for sample size calculation. After detailed examination and investigations, patients who underwent open appendectomy as per advice of visiting consultants were included; by filling predesigned research per forma. Results: Mean age of the patients was 26.33±11.177 and more than half were male i-e 106 (60.9%). Where majority i-e 93(53.4%) of appendices were of obstructed type, this wasn’t statistically higher than the non-obstructed type (p=0.363). In frequency of operative findings, acutely inflamed appendix was most common with 71(40.8%) patients. While suppurative, gangrenous and perforated samples were noted in 55(31.6%), 13(7.5%) and 8(4.6%) cases respectively. Negative appendectomy was done in 27(15.5%) patients. Conclusion: This study concluded that obstruction was noted in more than half of the cases i-e 93(53.4%), but it was not statistically higher from the other subtype. Negative appendectomy rate was 15.5%; higher than globally set target, but was similar to the one noted in Pakistan by previous researchers.
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