Risk factors for abdominal wound dehiscence after emergency laparotomy
DOI:
https://doi.org/10.18203/2320-6012.ijrms20261874Keywords:
Abdominal wound dehiscence, Emergency laparotomy, Surgical site infection, Hypoalbuminemia, Peritonitis, Risk factorsAbstract
Background: Abdominal wound dehiscence (AWD) is a serious postoperative complication following emergency laparotomy and is associated with substantial morbidity and mortality. This study was performed to determine the incidence of AWD and to identify significant preoperative, intraoperative and postoperative risk factors.
Methods: A retrospective observational study was conducted on 300 adult patients undergoing emergency open laparotomy at a tertiary care teaching hospital. Demographic, clinical and laboratory parameters were recorded. Categorical variables were analysed using Chi-square or Fisher’s exact test and continuous variables using independent t-test. Variables with p<0.10 on univariate analysis were entered into multivariate logistic regression. A p<0.05 was considered statistically significant.
Results: The overall incidence of AWD was 7.0% (21/300). On univariate analysis, surgical site infection (OR 6.9; 95% CI 3.1–15.2; p<0.001), hypoalbuminemia (OR 5.1; 95% CI 2.4–10.7; p=0.002), peritonitis (OR 4.2; 95% CI 2.0–8.9; p=0.004), anemia (OR 3.1; 95% CI 1.4–6.7; p=0.01), operative duration >3 hours (OR 2.6; 95% CI 1.2–5.6; p=0.02) and postoperative sepsis (OR 3.0; 95% CI 1.3–6.9; p=0.01) were significantly associated with AWD. Multivariate analysis identified surgical site infection (adjusted OR 5.8; 95% CI 2.6–12.9; p<0.001), hypoalbuminemia (adjusted OR 4.2; 95% CI 1.9–9.1; p=0.001) and peritonitis (adjusted OR 3.6; 95% CI 1.6–8.0; p=0.003) as independent predictors.
Conclusions: Infective and nutritional factors are major determinants of abdominal wound dehiscence following emergency laparotomy. Early identification and optimization of these risk factors may reduce postoperative morbidity and mortality.
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