Complete dehiscence of the abdominal wound and incriminating factors.

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.