Complete Dehiscence of the abdominal wound and incriminating factors

Second Surgical Department of Medical Faculty of the Aristoteles University of Thessaloniki, G Gennimatas Hospital, Greece.
The European Journal of Surgery 06/2001; 167(5):351-4; discussion 355. DOI: 10.1080/110241501750215221
Source: PubMed


To find out the causes of abdominal wound dehiscence.
Retrospective study.
University hospital, Greece.
Abdominal wound dehiscence occurred in 89 cases out of 19,206 major abdominal operations including 4671 emergencies during the past 15 years (0.5%).
In the study group 14 local and systemic risk factors were analysed and compared with those in a control group of 89 patients who had similar procedures without dehiscence.
Statistical analysis using the chi square test.
Significant factors (p < 0.05) included age over 65 years, emergency operation, cancer, haemodynamic instability, intra-abdominal sepsis, wound infection, hypoalbuminaemia, ascites, obesity, and steroids. Risk factors that were not significant included sex, anaemia, diabetes mellitus and pulmonary disease. Overall morbidity and mortality were 30% and 16%, respectively. The mortality and the possibility of dehiscence seem to correlate directly with the number of risk factors.
Patients with these risk factors require more attention and special care to minimise the risk of its occurrence.

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    • "Patients younger than 18 y and those with an incision length of <10 cm were excluded from the study. Patients who died in the 2-wk period after the surgery were considered lost to follow-up because most fascial dehiscences occur during this period [18] [19]. The types of surgery were categorized as malignancy resection, gastrointestinal (GI) obstruction, GI bleeding, intra-abdominal infection, trauma, and miscellaneous. "
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