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Complete dehiscence of the abdominal wound and incriminating factors
T E Pavlidis1, I N Galatianos, B T Papaziogas
1Second Surgical Department of Medical Faculty of the Aristoteles University of Thessaloniki, G Gennimatas Hospital, Greece.
Objective:
To find out the causes of abdominal wound dehiscence.
Design:
Retrospective study.
Setting:
University hospital, Greece.
Subjects:
Abdominal wound dehiscence occurred in 89 cases out of 19,206 major abdominal operations including 4671 emergencies during the past 15 years (0.5%).
Interventions:
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.
Main Outcome Measures:
Statistical analysis using the chi square test.
Results:
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.
Conclusion:
Patients with these risk factors require more attention and special care to minimise the risk of its occurrence.