Operative Findings and Outcome of Abdominal Wound Dehiscence in Emergency Laparotomy

Abstract

Introduction: Dehiscence is the partial or complete separation of previously approximated wound margins as a result of inadequate wound healing. Wound dehiscence is most common following an open wound surgery. It's also known as wound breakdown, wound disruption, or wound separation. Various preoperative and postoperative variables might impact it, and these factors can also influence the patient's result following surgery. Aim of the Study: The aim of the study was to observe the operative findings and outcome of patients with abdominal wound dehiscence that had undergone emergency laparotomy. Methods: This prospective clinical study was conducted at the Department of Surgery, MAG Osmani Medical College, Sylhet, Bangladesh. The study duration was 8 months, from July 2008 to February 2009. A total of 460 participants were selected from those undergoing emergency laparotomy in the study place for this study. A consecutive selection method was followed for the selection of the participants. The participants were divided into two groups depending on whether wound dehiscence was developed or not. Result: All the baseline characteristics (age, body mass index, and smoking habit) of patients except sex were significantly associated with wound dehiscence. The history of receiving steroid and cytotoxic drug were higher in patients with wound dehiscence than that in patients without wound dehiscence. However, the history of receiving the immunosuppressive drug was almost identical between the groups. The patients who did not take hygienic measures or take bath before an operation or change clothing had a higher incidence of wound dehiscence. The mean duration of operation, prolene suture used for closure, midline incision, mass closure technique and drain given had significant influence on development of wound dehiscence. Presence of ascitic fluid, pus and contaminated faecal material demonstrated their significant presence in patients who develop wound dehiscence than .....