Clinical Study on Factors Influencing Wound Dehiscence in Emergency Exploratory Laparotomy

Talukdar, Mrinal; Gopalarathnam, Sankamithra; Paul, Rajesh; Shaan, Abdul Rahim

doi:10.14260/jemds/2016/457

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…The incidence of wound complications is highest in subjects having pulmonary diseases (9 out of 12 patients ie 75%). These findings are comparable with the study of Talukdar M et al (15), in which out of total 213 patients 27 had wound dehiscence and its prevalence in anaemia, hypoalbuminemia, post-operative pulmonary complications, increased intraabdominal pressure, intra-abdominal sepsis/wound infection, delayed presentation and malignancy. So perioperative management of these co morbidities plays a major role in wound healing and complications.…”

Section: Observation and Resultssupporting

confidence: 90%

Management and Outcome of Abdominal Wall Closure in Emergency Laparotomy at a Tertiary Care Centre

Badgurjar

Thakor

Saxena

et al. 2021

IJMBS

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Objective: Abdominal wall closure of an emergency laparotomy involves a great deal of consideration. An ideal laparotomy wound closure should be efficient. provide strength and serve as a barrier to infection. The aim of this study is to compare and evaluate the advantages of layered closure in comparison with the mass layered closure, the types of suture materials used in the closure, absorbable/nonabsorbable and its correlation with post operative complications such as wound sepsis, burst abdomen and incisional hernia. Methods: This prospective study was carried out over a period of 18 months enrolling a total of 90 patients split into two groups with group 1 undergoing mass closure using both interrupted and continuous methods and group 2 undergoing layered closure using both interrupted and continuous methods of suturing. Results: A higher rate of wound complications was noted in the layered closure group (37.7%) than the mass closure group (17%). Wound complications were also noted to be higher in closures done with prolene suture (37.7%) than PDS (20%). As far as techniques were concerned, interrupted and continuous suturing had a similar rate of complications. Of all the comorbidities, considered in the study, the highest rate of wound related complications were seen in patients with pulmonary complications (13.3%). Conclusion: Although the ideal way to close an abdomen post laparotomy has not yet been discovered, our study shows that mass closure with PDS suture to close the abdominal wall should be advocated as there is decreased early and late post operative wound complications Keywords: PDS.

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Section: Observation and Resultssupporting

confidence: 90%

Management and Outcome of Abdominal Wall Closure in Emergency Laparotomy at a Tertiary Care Centre

Badgurjar

Thakor

Saxena

et al. 2021

IJMBS

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“…Kenig et al reported no significant differences between the study and control groups regarding anemia, which is synonymous with our study. Similar findings were reported by Talukdar et al [ 20 ]. However, van Ramshorst et al reported that 33% of cases were uremic [ 3 ].…”

Section: Discussionsupporting

confidence: 92%

A Prospective Study on the Outcome After Mass Closure of Post-laparotomy Wound Dehiscence in a Tertiary Care Hospital, Tamil Nadu, India

Murugavel,

Vajiravelu Thirunavukkarasu,

Gnana Chellaiyan

et al. 2024

Cureus

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The ideal abdominal wound closure provides strength and a barrier to infection. The major cause of morbidity following any laparotomy is abdominal wound dehiscence. For prompt patient recovery and outcome factors influencing wound healing following mass closure of post-laparotomy, wound dehiscence patients are evaluated in this present study. The aim of the study was to evaluate the outcome and various complications following mass closure of post-laparotomy wound dehiscence. Materials and methodsA prospective study was conducted among 50 patients admitted to the Department of General Surgery, Tamil Nadu, India, with wound dehiscence following emergency and elective laparotomy surgeries managed with mass closure during the study period from 2021 to 2022. The chi-square test and Fischer's exact test were done. ResultsMass closure of post-laparotomy wound dehiscence was more common among males (74%, n=37) and less common in the age group 20-30 years (12%, n=6). Prolonged bleeding time and clotting time post-surgery were associated with the type of surgery with a significant p-value of 0.007 and 0.001, respectively, by Fischer's exact test. The presence of urine albumin was also associated with the type of surgery with a significant p-value of 0.02. Surgical site infection (postoperative complication) was associated with the type of surgery and operating time with a significant p-value of 0.004 and 0.03, respectively. ConclusionAbdominal wound dehiscence is a serious and challenging postoperative complication that necessitates immediate intervention. Strict postoperative care places emphasis on reducing the risk of wound infection and other factors related to wound dehiscence.

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“…Pasien dengan hipoalbuminemia (albumin <3,5g/dL) mempunyai kemungkinan 16 kali lebih besar untuk terjadinya dehisensi bila dibandingkan dengan yang memiliki kadar albumin normal. 21 Hipoproteinemia berhubungan dengan penyembuhan luka yang buruk karena terdapat penurunan sintesis kolagen pada luka operasi maupun tempat anastomosis. 22,23 Hipoproteinemia menghambat respon imun, yaitu aktivasi makrofag dan pembentukan granuloma.…”

Section: Metodeunclassified

“…24 Hipoproteinemia memperpanjang fase inflamasi dan menganggu fibroplasia, proliferasi pro-teoglikan, dan sintesis kolagen sehingga meng-hambat neoangiogenesis serta proses remodeling. 21 Anemia merupakan faktor yang berpengaruh pada penyembuhan luka yang buruk. Namun hal ini masih menjadi perdebatan.…”

Section: Metodeunclassified

Faktor Prediktor Dehisensi pada Neonatus dengan Pembedahan Abdominal

Pravitasari

Wandita

Prawirohartono

2018

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Latar belakang. Dehisensi luka operasi merupakan komplikasi operasi yang jarang, tetapi sering menyebabkan kematian. Faktor risiko yang dilaporkan adalah usia kurang dari 1 tahun, gizi buruk, hipoalbuminemia, infeksi berat, insisi median, dan operasi yang bersifat darurat. Tujuan. Untuk mengetahui sepsis, anemia, hipoalbuminemia, trombositopenia, jenis kelamin laki-laki, operasi darurat, kurang bulan dan berat lahir rendah dapat digunakan sebagai prediktor dehisensi pada neonatus dengan pembedahan abdominal. Metode. Dilakukan penelitian kohort retrospektif dari data rekam medis pada 159 neonatus dengan pembedahan abdominal. Analisis dilakukan dengan menghitung angka kejadian dehisensi. Analisis bivariat digunakan untuk menentukan risiko relatif dan analisis multivariat digunakan metode regresi Cox untuk mengetahui hazard rasio berdasarkan waktu terjadinya dehisensi. Hasil. Angka kejadian dehisensi pada neonatus dengan pembedahan abdominal adalah 39/159 (24,5%) kasus. Rerata waktu kejadian adalah hari ke-11 (kisaran 5-28 hari) pascaoperasi. Rerata lama hari rawat pasien dengan dehisensi lebih panjang, yaitu 36 (5-96) dibandingkan dengan yang tidak dehisensi 21 (2-155) hari (p=0,001). Terdapat 28,2% 11/39 (28,2%) kasus dengan infeksi luka operasi dan angka kematian (9/39 (25%) kasus. Tidak didapatkan faktor prediktor yang bermakna untuk terjadinya dehisensi pada neonatus dengan pembedahan abdominal. Kesimpulan. Tidak didapatkan faktor prediktor yang bermakna untuk terjadinya dehisensi pada neonatus dengan pembedahan abdominal. Diperlukan penelitian lanjutan dengan desain yang lebih baik, yaitu secara prospektif dan mempertimbangkan faktor prediktor lain, seperti status gizi, penyakit penyerta (penyakit sistem respirasi, instabilitas hemodinamik) serta faktor intraoperatif (lama, jenis insisi dan jenis penutupan luka). Sari Pediatri 2017;19(3):131-8Kata kunci : dehisensi, neonatus, pembedahan abdominal, faktor prediktor, luaran Predictor Factors of Abdominal Wound Dehiscence in NeonatesLucy Pravitasari, Setya Wandita, Endy P. Prawirohartono Background. Abdominal wound dehiscence is a rare complication of surgery but often fatal. The risk factors from previous studies were age less than 1 year, malnutrition, hypoalbuminemia, severe infection, median incision and emergency surgery. Objective. To determine whether sepsis, anemia, hypoalbuminemia, thrombocytopenia, male gender, emergency surgery, preterm and low birth weight (LBW) are predictors of dehiscence in neonates with abdominal surgery. Methods. We conducted a retrospective cohort study using medical records involving 128 neonates with abdominal surgery at Sardjito Hospital, Yogyakarta in Januari 2011-December 2016. We calculated the incidence of dehiscence and relative risks with 95% confidence interval of predictors of dehiscence by multivariate analysis. Results. The incidence of dehiscence in neonates with abdominal surgery was 39/159 (24.5%). Average time of occurrence was day 11 (range 5-28 days) after surgery. Hospital stay was significantly longer (p=0....

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Clinical Study on Factors Influencing Wound Dehiscence in Emergency Exploratory Laparotomy

Cited by 4 publications

References 20 publications

Management and Outcome of Abdominal Wall Closure in Emergency Laparotomy at a Tertiary Care Centre

Management and Outcome of Abdominal Wall Closure in Emergency Laparotomy at a Tertiary Care Centre

A Prospective Study on the Outcome After Mass Closure of Post-laparotomy Wound Dehiscence in a Tertiary Care Hospital, Tamil Nadu, India

Faktor Prediktor Dehisensi pada Neonatus dengan Pembedahan Abdominal

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