Incidence of Wound Dehiscence Following Obstetric and Gynecological Surgeries at a Tertiary Care Hospital: A Retrospective Study

Abstract

Aim: A retrospective analysis with an aim to find out the incidence of wound dehiscence following obstetric and gynecological surgeries was carried out at a referral hospital and to review some of the practices in the hospital surgical and postoperative care of the surgical wound. Materials and methods: This study was carried out in the Department of Obstetrics and Gynecology at KLEs Dr Prabhakar Kore Charitable Hospital, a tertiary referral hospital in Belagavi, Karnataka, India, from May 2016 to August 2017 by obtaining data from medical records in the hospital. Results: During the study period, 3,172 women underwent major obstetric and gynecological surgeries; out of which 97 women developed wound dehiscence (3.05%). A total of 82 women had wound dehiscence following obstetric surgeries (84.54%) and 15 women following gynecological surgeries (15.46%). The number of emergency surgeries were 79 (81.44%), which included emergency lower segment cesarean section (LSCS) and the elective cases were 18 (18.56%), which comprised of elective LSCS, tubal ligation, and gynecological surgeries. Conclusion:The aim of this study was to review some of the practices during surgery and postoperative care in our hospital. The practice of scrubbing the abdomen prior to the day of surgery was followed. Subcutaneous fat suturing before closing the skin with subcuticular sutures was never practiced even when the fat layer was quite thick. Dressing was routinely changed on the 3rd day in the postnatal ward (exposing the wound to dirty linen particles when the wound had still not healed). However, preoperative antibiotics were routinely given prior to incision and also postoperative antibiotics for a total of 5 days. Clinical significance: Intraoperative and postoperative factors are significant in wound healing in addition to patient factors. Dressing should probably be done first only on the 5th postoperative day, which may prevent introduction of infection.

Surgical Site Infections Following Cesarean Section: A Longitudinal Study

“…In a study done by Metgud MC and team, dressing change on third day postoperatively had increased risk of infection. 18 Advancing age is a parameter that might impair healing postoperatively, which we also observed postoperatively. In a study done by Abbey et al, the rate of SSI was significantly higher than the group of younger patients.…”

Insights on Postoperative Infections in Gynecology: A Narrative Review

“…15 With the production of both exogenous and endogenous flora, it leads to increase in wound gape was also studied. 16 The dominant organisms in gynecological procedures are gram-positive cocci that is group B streptococci, enterococci, staphylococci. Also anaerobic gram-positive cocci like peptococci, and pepto streptococci organisms, aerobic gram-negative bacilli like E. coli, Klebsiella pneumonia, and proteus species.…”

Regeneration Therapy: The Role of Platelet-Rich Plasma in Post-hysterectomy Wound Dehiscence Healing

“…Post-hysterectomy scar dehiscence occurs around 0.6% of the time worldwide [ 1 ]. A lower segment caesarean section, a traditional caesarean section, or prior uterine trauma would be typical significant factors [ 2 , 3 ]. The triad of ileus, vomiting, and coughing, as well as obesity, pre-existing pulmonary and cardiovascular conditions, vertical incisions, and, to a lesser extent, hypoproteinaemia, electrolyte and fluid imbalance, and wound infection, are the variables that are related to the risk of wound dehiscence [ 4 , 5 ].…”