A cinical study of abdominal wound dehiscence at a tertiary care Centre in North India

• Author Details:   
• Sushil Singhal
• Shreya Srivastava
• Deeksha Agrawal
• Sanjeev Singhal
• Parul Garg ^*

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Introduction: One dangerous postoperative complication that has a high death and morbidity rate is wound dehiscence. Wound dehiscence can be caused by a variety of risk factors, including emergency surgery, intra-abdominal infection, malnutrition, advanced age, systemic disorders, and so on. Understanding these risk variables is essential for effective prophylaxis.Wound infection increases the risk of wound dehiscence because of influx and activation of neutrophils, increases in levels of degradative matrix metalloproteinases and the release of endotoxins. Medical and surgical preventive measures are crucial throughout the primary peri-operative phase due to the high death rate.

Aims and Objective: To determine the frequency and important risk factors associated with abdominal wound dehiscence.

Materials and Methods: A total of 100 post operated abdominal surgical wound dehiscence patients were studied. Date of admission, clinical history, important risk factors, investigations, and postoperative infection were recorded.

Result: Eighty seven individuals underwent emergency surgery which were contaminated type. 72 patients had a BMI of 22 or above. Sixty three patients underwent midline incision surgery while 42 patients had intestinal perforation resulting in peritonitis. From pus discharge patient, E. coli was reported (42%) followed by Klebsiella pneumoniae (38%), Enterococcus spp (18%), Staphylococcus aureus (36%) and Streptococcus pyogens (6%), which were mostly multidrug resistant.

Conclusion: Male sex, older age, anaemia, malnutrition, obesity, obstruction of the intestines, emergency surgery, perforation closure and presence of infection are significant contributory variables for development of postoperative abdominal wound dehiscence. Effective aseptic procedures during surgery and following hospital infection control guideline are much needed for preventing wound dehiscence related complications.