A PROSPECTIVE STUDY ON THE INCIDENCE AND RISK FACTORS OF WOUND DEHISCENCE OF EMERGENCY LAPAROTOMY SURGERIES IN A TERTIARY CARE HOSPITAL

Introduction: Abdominal wound dehiscence is one the major complications of emergency laparotomy. It can range from minor wound gap to more serious emergency condition like burst abdomen and intensive care. It is one of the major causes of morbidity and mortality in emergency surgeries. Several risk factors have been identified as possible causes of wound dehiscence. Materials and Methods: The prospective observational study was conducted on 80 patients undergoing midline laparotomy in the emergency surgency. Informed written consent was obtained from all the participants after approval from the ethical committee of the institution. Complete evaluation of all patients with thorough history and clinical examination was done. Preoperative investigations were reported and underlying corrections were done. After proper resuscitation and preparation, patients were sent to operation room for surgery. Results: Out of the 80 cases on which emergency laparotomy were done, wound dehiscence was observed in 13 cases (16.25%). The highest incidence was found in the elderly age group (>60years) and highest in the emergency laparotomies indicated for bowel perforation with peritonitis. Timing of presentation and duration of surgery along with lab abnormalities like anemia, low serum albumin, uremia is thought to predispose to wound dehiscence. Intra-abdominal distension and paralytic ileus was also predisposing factors in post-operative period. Conclusion: abdominal wound dehiscence especially when done in emergency setting had higher risk of wound dehiscence due to less time for correction of underlying causes and lack of sterile techniques due to higher load of emergency cases. Emphasis has to be given in the reducing the modifiable risk factors.