A CLINICAL STUDY OF THE FACTORS AFFECTING POST LAPAROTOMY WOUND HEALING

Abstract

BACKGROUND: Wound Healing is the summation of a number of processes that follow injury. Despite immense advances in the technique of wound creation and closure, there continues to be an important percentage of patients undergoing abdominal operations, suffering from delayed wound healing and partial wound failure. Apart from increasing patient morbidity and hospital stay, it also is a psychological blow to both the surgeon and patient alike. The incidence of post-operative wound dehiscence was investigated in patients in several studies (e.g., 1.25 per 1,000 discharges at 0 to 17 years, 1.74 at 18 to 44 years, 2.65 at 45 to 65 years, and 3.77 at 65 or more years. Additionally, it was found that this complication resulted in an increased mean length of stay (by 21.1 days) and a tremendous increase in charges for affected patients, with 5.7 times higher odds of in-hospital mortality.Wound Infection rate varies from 6.8 percent to 21.4 percent depending on the procedure and other patient factors. The aim of this study is to assess the various factors inuencing post laparotomy wound healing. To identify the pre-operative, operative and post operative risk factors in patients having poor wound healing. RESULTS This prospective study was conducted in Government General Hospital, kurnool. A total of 100 patients undergoing laparotomies were studied .40 patients were found to have delayed wound healing. The strongest association for delayed healing was found to be wound infection, followed by chronic cough,steroids and poorly controlled diabetes. CONCLUSIONS The incidence of delayed healing was found to be higher in our study with increased incidence of wound infection. It was found that emergency laparotomies were associated with an increased incidence of wound infection and thereby delayed healing. Poor wound healing is also associated strongly with poor nutrition and uncontrolled diabetes. These factors should be taken into account and efforts have to be made to correct the risk factors pre or post-operatively.