Abdominal Wound Dehiscence: Retrospective review on pattern, associated factors and management outcome of patients operated at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Abstract Background: Abdominal wound dehiscence (AWD) is separation of different layers of an abdominal wound before complete healing has taken place. The magnitude of wound dehiscence VI varies from hospital to hospital worldwide while it is recorded to be 1-3% in most hospitals with an impact of mortality rate as high as 45%. Objectives: The aim of this study is to assess the prevalence of abdominal wound dehiscence, associated factors and management outcome of patients operated at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia Methods: A hospital based retrospective review of chart was done by using the data covering the past three years (September 2014 – September 2017)and data was collected from hospital medical records of sampled patients like OR log books, and individual patient medical records. The collected data were checked for any inconsistency, coded and entered into SPSS version 20 for data processing and analysis. The bivariate and multivariate analysis was done to see the significance association between abdominal wound dehiscence and the independent variables at p-value<0.05. Results a total of 41(0.99%) patients developed abdominal wound dehiscence from September 2014 to September 2017 among 4137 patients who underwent abdominal laprotmy at SPHMMC department of Surgery. Among the patients, the majority 51.2% were in age range of 41 and above years with mean age 2.98 (SD=1.21) and 70.7% were male. Also, abdominal wound dehiscence was more common in emergency patients and vertical incision was the most common types of incision and 58.5% of the Wound Dehiscence was developed within 6-10 days of postoperative course95.2%of them underwent re-laparatomy for the management of the wound dehiscence and 48.8% of them were treated with Tension suture during the 2nd operation of abdominal closure. Conclusion: The current study revealed that the overall magnitude of Abdominal Wound Dehiscence at study area was 0.99% and among this, 4.9% and 95.1% were partial wound dehiscence and complete wound dehiscence respectively. During the multivariate analysis there was no any factor which has significant association with abdominal wound dehiscence. However, regarding the management outcome, 9.8% of patients died within the institution after the second operation which is high mortality rate. Abdominal Wound Dehiscence was relatively higher among those patients operated for emergency case (90%) than elective ones during the 1stsurgery. Key Words: wound dehiscence, postoperative, evisceration, Emergency operation, Midline incision