A PROSPECTIVE STUDY FOR PREDICTORS OF POST LAPAROTOMY ABDOMINAL WOUND DEHISCENCE

Abstract

INTRODUCTION: Abdominal wound dehiscence, whether partial or complete, is a major morbidity and a leading cause of mortality in abdominal surgeries. Wound dehiscence or evisceration is the most dreaded complication faced by surgeons and of greatest concern because of risk of evisceration, the need for immediate intervention, possibility of repeat dehiscence, surgical wound infection and incisional hernia formation. In this study various predictors or risk factors are taken into account to observe the association with abdominal wound dehiscence. MATERIAL AND METHOD: The study was done on 50 patients who developed abdominal wound dehiscence post laparotomy after considering the inclusion and exclusion criteria. RESULT: During the study it was observed that Pre-operative factors like old age, male sex, anemia, malnutrition, obesity, diabetes mellitus, peritonitis, emergency surgery, high ASA score are factors leading to post-operative wound dehiscence. Intra-operative factors like contaminated wound, midline incision, poor suturing technique,improper suture material choice, inexperience surgeons are associated with the increase incidence of wound dehiscence. Post-operative factors like cough, post- operative ventilator support, hypoxia, abdominal distension, wound infection also increase the rate of wound dehiscence. CONCLUSION: Preventive measures are prophylactic optimization of patient's co-morbid conditions, improving the nutritional status of the patient, proper aseptic technique, optimizing patient lung condition, avoiding other straining conditions like cough, vomiting and by applying proper surgical technique with adequate skill acquisition. Good preoperative preparation reduces postoperative wound complications.