Risk Factors of Wound Dehiscence After Laparotomy and the Role of Prophylactic Retention Sutures
Iraqi Postgraduate Medical Journal,
2016, Volume 15, Issue 1, Pages 67-72
BACK GROUND :
(laparatomy wound dehiscence) is a serious postoperative complication which is associated with high morbidity and mortality rates.
To evaluate abdominal wounds dehiscence in term of risk factors and to assess the role of prophylactic retention suture in prevention of wound dehiscence.
PATIENTS AND METHOD:
Prospective study done in the General Surgical unit of Al–Imamain Alkadhmain medical city on 167 patients with 20 patients underwent prophylactic retention suture, from the 1stof July 2013 to the 1st of July 2015.and to know the effect of different factors on incidence of wound dehiscence.
The number of wound dehiscence cases was 19 patients out of whole total 167 patients which represent 11.38%. Wound infection was present in 63 patients out of 167 patients (37.2%) and 19 patients out of 63 patients (30.2%) developed wound dehiscence. The other risk factor was chest complication which was present in 76 patients out of 167 patients (45.5%). and 17/76 patients (22.4%) developed wound dehiscence. Smoking was present in 92/167 patients, anemia was present in 80/167 patients and 13/80 patients (16.3%) developed wound dehiscence. Age > 50 years was present in 53/167 patients and 10 /53 patients (18.9%) developed wound dehiscence. steroid usage found in 17/167 patients and 5/17 of them patients (29.4%) developed wound dehiscence, and jaundice was present in 8/167 patients and two/8 patients (25%) developed wound dehiscence. Prophylactic retention sutures were done for 20 patients all of them were male with generalized peritonitis and emergency cases. 19 patients were anemic. 18 patients were smokers and 15 patients were above 50 years of age; from these 20 patients only one patient who had all listed risk factor developed wound dehiscence after prophylactic retention suture wound inspected from 2ndpost-operative day on word
Post-operative wound dehiscence rate in the surgical unit of Al–Amamain Alkadhmain medical city is 11.38% and that wound infection, emergency operations and compromised immunity, are factors which increase the rate of wound dehiscence; and prophylactic retention sutures is a valuable maneuver to reduce it.
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