Complete dehiscence of the abdominal wound and incriminating factors

Abstract

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.