[Wound dehiscence as a problem of the surgery department].

UNLABELLED: Eventration is still the great surgical problem. Although it is not very often, but may course serious complication leading to death. The aim of this study is the retrospective analysis of patients undergone surgery in the III Department of Surgery in 1982-1995 (14 years). During this period eventration was observed with 61 patients, constituting 1% of laparotomies performed in this period. Among the re-operated on, there were 40 males and 21 females. In 6 cases this complication occurred twice and in 1 case - three times. The age of patients ranged from 29 to 95, the average being 61.5. The usual time spent in the Hospital was 35.9 days. There were 51 patients (83.6%) admitted and operated in the surgical casualty. Among those there were cases of diffuse peritonitis, bowel obstruction, gastro-intestinal hemorrhage etc. In 40% of patients the eventration occurred in 5 days after surgery (the average time was 6.5 days). Eventration was not found after 2 weeks following the operation. Wound infection, the most common cause of dehiscence, was observed in 29 cases (47.5%). During the reoperation, in 10 patients we diagnosed bowel obstructions, in 6 - jejunal fistula and in other 6 - abdominal abscess. 24 (39.3%) patients died in the period following the operation because of septicemia, cardiovascular and respiratory deficiency. In 1/3 cases there were pulmonary complications. Authors draw attention to the prevention of wound dehiscence as well as to the additional suturing procedure which has been successfully used in their Department.

CONCLUSION

Wound dehiscence is the surgical complication with the high risk of death.