STUDY OF PREDICTORS OF WOUND DEHISCENCE IN MAJOR ABDOMINAL SURGERIES
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Keywords
Wound dehiscence, abdominal surgery, risk factors, hypoalbuminemia, surgical site infection, emergency laparotomy, postoperative complications
Abstract
Wound dehiscence is a serious postoperative complication following major abdominal surgeries, contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs. Identifying predictive risk factors is essential for early recognition and prevention.
Objective: To evaluate the incidence of wound dehiscence and identify significant preoperative, intraoperative, and postoperative predictors in patients undergoing major abdominal surgeries at a tertiary care hospital.
Methods: This prospective observational study was conducted over one year in the Department of Surgery, Maharshi Vishwamitra Autonomous State Medical College (MV ASMC), Ghazipur, Uttar Pradesh. A total of 420 adult patients undergoing major abdominal surgeries were enrolled. Data on demographics, comorbidities, surgical details, and postoperative complications were collected. Wound dehiscence was defined as partial or complete disruption of the abdominal wound involving the fascial layer. Statistical analysis included univariate and multivariate logistic regression to identify independent predictors.
Results: Wound dehiscence occurred in 28 patients (6.67%). Significant risk factors in univariate analysis included anemia (p=0.001), hypoalbuminemia (p=0.004), diabetes mellitus (p=0.013), emergency surgery (p=0.002), surgical site infection (p<0.001), and operative time >180 minutes (p=0.016). Multivariate analysis identified hypoalbuminemia (OR=3.96; p=0.005), emergency surgery (OR=2.73; p=0.028), and surgical site infection (OR=5.81; p<0.001) as independent predictors of wound dehiscence.
Conclusion: Wound dehiscence is a multifactorial complication with preventable risk factors. Hypoalbuminemia, emergency surgery, and postoperative infection were found to be the most significant predictors. Preoperative nutritional optimization, rigorous aseptic practices, and close monitoring of high-risk patients are essential strategies to reduce its incidence and improve surgical outcomes.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Rajesh Kumar Singh
Associate Professor, Department of Surgery, MV ASMC Ghazipur,UP,
Sanjay Chaube
Ex Prof. Surgery, Department of Surgery, Shri Gorakhnath Medical College, Gorakhpur, UP,