Risk factors of abdominal wound dehiscence in abdominal surgery

Самарцев, В А; Гаврилов, В А; Кузнецова, М В; Кузнецова, М. П.

doi:10.17116/hirurgia202010168

Cited by 1 publication

(7 citation statements)

References 6 publications

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“…Many patient-own, non-influenceable risk factors as well as influenceable risk factors in the context of surgery and postoperative treatment are discussed [ 1 , 2 , 4 , 6 , 9 ]. In the literature, advanced age and male gender are associated with a higher risk [ 2 , 5 , 11 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…A chronic cough could lead to an increase in abdominal pressure and, therefore, an increased risk of FD, in line with the literature, although in our study a cough alone was not shown to be an independent risk factor. Other known risk factors with abdominal pressure increase are ascites and vomiting [ 7 , 9 , 11 , 16 ]. In our study, a clear connection between sudden increase in pressure in the course of coughing and rupture of the wound was found in two cases.…”

Section: Discussionmentioning

confidence: 99%

“…Van Ramshorst et al and Samartsev et al found no association between previous laparotomy and FD. However, the temporal distance to the relaparotomy was not specified [ 9 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of the consequences for the individual patient, FD is a considerable, avoidable financial burden for the health care system due to prolonged hospital stays, longer intensive therapy and the necessary reoperation with longer convalescence time of the patient [ 6 , 9 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…This has led to various retrospective studies being conducted to identify risk factors, some of which have produced contradictory results [ 1 , 5 , 6 , 9 , 11 , 15 , 16 ]. Further studies were conducted to develop a risk model for preoperative identification of increased risk, although these risk models have not yet been established in clinical practice [ 11 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Abdominal fascia dehiscence: is there a connection to a special microbial spectrum?

Stropnicky

Kandemir

Schäffer

et al. 2022

Hernia

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Introduction Acute fascia dehiscence (FD) is a threatening complication occurring in 0.4–3.5% of cases after abdominal surgery. Prolonged hospital stay, increased mortality and increased rate of incisional hernias could be following consequences. Several risk factors are controversially discussed. Even though surgical infection is a known, indisputable risk factor, it is still not proven if a special spectrum of pathogens is responsible. In this study, we investigated if a specific spectrum of microbial pathogens is associated with FD. Methods We performed a retrospective matched pair analysis of 53 consecutive patients with an FD after abdominal surgery in 2010–2016. Matching criteria were gender, age, primary procedure and surgeon. The primary endpoint was the frequency of pathogens detected intraoperatively, the secondary endpoint was the occurrence of risk factors in patients with (FD) and without (nFD) FD. Results Intraabdominal pathogens were detected more often in the FD group (p = 0.039), with a higher number of Gram-positive pathogens. Enterococci were the most common pathogen (p = 0.002), not covered in 73% (FD group) compared to 22% (nFD group) by the given antibiotic therapy. Multivariable analysis showed detection of Gram-positive pathogens, detection of enterococci in primary laparotomy beside chronic lung disease, surgical site infections and continuous steroid therapy as independent risk factors. Conclusion Risk factors are factors that reduce wound healing or increase intra-abdominal pressure. Furthermore detection of Gram-positive pathogens especially enterococci was detected as an independent risk factor and its empirical coverage could be advantageous for high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Van Ramshorst et al and Samartsev et al found no association between previous laparotomy and FD. However, the temporal distance to the relaparotomy was not specified [ 9 , 11 ].…”

Section: Discussionmentioning

confidence: 99%