Online ISSN: 2515-8260

Keywords : Burst abdomen


A Study to Observe the Cases of Abdominal Wound Dehiscence in Patients Undergoing Emergency Laparotomy with Midline Incision

Dr. Amuleek Kaur, Dr. Karaninder Singh Wilku,Dr. Gopal Swaroop Bhargava,Dr. Ajaypal Singh Sandhu .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 79-86

Aim: A study to observe the cases of abdominal wound dehiscence in patients undergoing emergency laparotomy with midline incision.
Objectives: To calculate the frequency of abdominal wound dehiscence in patients undergoing emergency laparotomies subjected to midline incision and to determine hypoproteinemia, anemia and surgical site infection as contributing factors for abdominal wound dehiscence in emergency laparotomies with midline incision.
Materials and Methods: Observational cohort study carried out in the department of General Surgery at Sri Guru Ram Das University of Health Sciences, Vallah, Sri Amritsar on 60 patients who underwent emergency laparotomy with midline incision.
Results: In our study, patients belonging to various kinds of age group and socio economic background were included in the study irrespective of the gender. Amongst the 60 patients included, abdominal wound dehiscence was seen in 36 patients corresponding to 60% of the sample size. This study was endeavoured to delineate the role of anemia, hypoalbuminaemia and SSI (surgical site infection) in the dehiscence seen in these patients and it was observed that majority of the patients undergoing abdominal wound dehiscence had hypoalbuminaemia thus, making it the most significant risk factor followed by anemia and surgical site infection.
Conclusion: In this study we concluded that Abdominal wound dehiscence is a serious sequel of impaired wound healing. Many factors can predispose to this grave complication of which anemia, hypoproteinaemia and surgical site infection carry enormous significance. Patients with these risk factors require more attention and special care to minimize the risk of occurrence. Postoperative abdominal wound dehiscence can be prevented by improving the nutritional status of the patient, strict aseptic precautions, optimization of patient's hemodynamic losses and by proper surgical technique. Early diagnosis of burst abdomen and aggressive treatment helps in reducing morbidity and mortality. Some of the major factors like the ones mentioned in this study must be vigilantly looked for and treated to prevent this catastrophic complication.

Risk Scoring for Burst Abdomen Prediction in Patients with Midline Laparotomy

Wael E. Lotfy; Ramadan M. Ali; Hassan R. Ashour; Mohamed Osama Elhady; Ahmed Raafat Abdel Fattah

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 984-990

 Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. The aim of the present study is to identify the different risk factors and high risk patients for burst abdomen for decreasing the rate of burst abdomen post operatively. Patients and methods: An observational analytical study included 110 patients and carried out in General Surgery Department, Faculty of Medicine, Zagazig University Hospitals. The patients were divided into 2 main groups: post-midline laparotomy burst abdomen patients and postmidline non complicated laparotomy with burst abdomen patients. Evaluation of different risk factors between the two groups was performed. Results: There is statistically significant relation between occurrence of burst abdomen and both smoking and obesity. There is statistically significant relation between occurrence of burst abdomen and all of direct trauma, diabetes, intraabdominal infection and jaundice. There is non-significant relation between occurrence of burst abdomen and other risk factors. There is statistically significant relation between occurrence of burst abdomen and postoperative ileus, pulmonary complications and wound infection. Diabetes, wound infection, smoking and direct trauma increased risk of burst abdomen by 47.205, 58.547, 40.559 and 39.874 folds respectively. Conclusion: Intra-abdominal infection is the most important factor in predicting burst abdomen. Patient factors like anemia, diabetes, smoking, peritonitis due to bowel perforation act as determinant for wound dehiscence. Postoperatively abdominal burst can be prevented by improving the nutritional status of the patient, early mobilization of the patient and simple investigations like Hemogram, RBS, RFT, LFT, chest x-ray may help to detect predisposing factors