Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;53(1):900-907.
doi: 10.1080/07853890.2021.1938661.

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

Shouxing Duan  1   2 , Xuan Zhang  3 , Xuewu Jiang  3 , Wenhui Ou  2 , Maxian Fu  2 , Kaihong Chen  2 , Xinquan Xie  2 , Wenfeng Xiao  2 , Lian Zheng  1 , Shuhua Ma  4 , Jianhong Li  2
Affiliations

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

Shouxing Duan et al. Ann Med. 2021 Dec.

Abstract

Background: Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, and neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD and construct a predictive model.

Methods: The clinical data of 453 cases that underwent neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were identified. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anaemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD.

Results: The incidence of neonatal AWD was 6.0% (27/453), among which partial wound dehiscence accounted for 4.9% (22/453) and complete wound dehiscence accounted for 1.1% (5/453). Hypoproteinemia and incision type were the independent risk factors for neonatal AWD, and weight at admission was a protective factor for AWD in the multivariate models. All these factors were incorporated to construct a nomogram, and a calibration curve was plotted. The result indicated that the actual risk was close to the predicted risk when the predicted risk rate was greater than about 35%.

Conclusions: Neonatal AWD is closely related to hypoproteinemia and incision contamination. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery.Key messagesNeonatal abdominal wound dehiscence (AWD) has a serious consequence and the incidence of neonatal AWD was about 6.0% and the complete AWD morbidity is 1.1%.Hypoproteinemia and incision type were the independent risk factors for neonatal AWD.Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery.

Keywords: Abdomen wound dehiscence (AWD); hypoproteinemia; incision contamination; neonates; risk factors; surgery.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Clinical outcomes in patients with independent risk factors and the overall events.
Figure 2.
Figure 2.
Nomogram for predicting AWD rate. The red and green indicate the confidence interval.
Figure 3.
Figure 3.
AWD nomogram calibration curve. The plot shows the relationship between the actual probability and predicted probability.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chirdan LB, Ngiloi PJ, Elhalaby EA.. Neonatal surgery in Africa. Semin Pediatr Surg. 2012;21:151–159. - PubMed
    1. Duan SX, Wang GH, Zhong J, et al. . Clinical analysis of entire abdominal wound disruption in neonates. J Clin Ped Sur. 2017;16:601–603,16.
    1. Jensen KK, Oma E, van Ramshorst GH, et al. . Abdominal wound dehiscence is dangerous: a nationwide study of 14,169 patients undergoing elective open resection for colonic cancer. Hernia. 2021;[online 2021 Jan 4]. DOI:10.1007/s10029-020-02350-z - DOI - PubMed
    1. Jiang XW, Chen ZX, Lai YM, et al. . Neonatal and infants abdominal wall incision dehiscence clinical features. J Appl Clin Pediatr. 2002;17:265–266.
    1. Di Saverio S, Tarasconi A, Walczak DA, et al. . Classification, prevention and management of entero-atmospheric fistula: a state-of-the-art review. Langenbeck’s Archives of Surgery. 2016;401:1–13. - PubMed

Publication types