A clinical study of abdominal wound dehiscence with emphasis on surgical management in Bangalore medical college and research institute, Karnataka, India

Abstract

Background: Wound dehiscence is described as partial or complete disruption of abdominal wound closure with or without protrusion of abdominal contents. It is among the most dreaded complications faced by surgeons and regarded as a severe postoperative complication, with mortality rates reported as high as 45%. Incidence in literature ranges from 0.4% to 3.5%.This study aimed at finding out the prevalence of abdominal wound dehiscence with different risk factors and also to study the effective management of abdominal wound dehiscence. Methods: All cases presenting with wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed including surgical incisions taken and the type of disease involved. A total of 60 cases were included in this prospective study. Data was analyzed using appropriate software. Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5th decade. Patients presenting with peritonitis secondary to hollow viscus perforation are more prone to abdominal wound dehiscence. Patients classified with contaminated wounds with emergency surgeries show higher predilection for wound dehiscence. Conclusions: Co morbidities like diabetes, malnutrition, anemia, COPD, play significant role in delaying wound healing. Simple routine laboratory investigations may help identifying predisposing factors and be corrected accordingly. Most of the patients can be managed conservatively and with secondary suturing without the need of re exploration and repeated surgery.