Clinical study of abdominal wound dehiscence in regional institute of medical sciences hospital, manipur

Wound dehiscence is disruption of any or all of the layers in a wound. Dehiscence may occur in up to 3% of abdominal wounds and is very distressing to the patient. Wound dehiscence is an acute wound failure. Acute wound failure has been discussed under various names i.e. wound dehiscence, burst abdomen, wound disruption and evisceration. Despite advances in perioperative care and suture materials, incidence and mortality rates in regard to abdominal wound dehiscence have not significantly changed over the past decades. This may be attributable to increasing incidences of risk factors within patient populations outweighing the benefits of technical achievements. This study was conducted to find out the incidence and identify the risk factors involved in causing abdominal wound dehiscence. 40 patients who developed abdominal wound dehiscence after laparotomy in department of surgery, RIMS Hospital were selected for cross sectional study during the study period of October 2013 to September 2015. Analysis was done with IBM SPSS version 16 and data were described using mean and percentages. Out of 1728 laparotomies during the study period which included 1008 cases of emergency laparotomies and 720 cases of elective laparotomies, 40 developed wound dehiscence, so incidence rate of abdominal wound dehiscence was 2.3% in this study; 1.9% for elective laparotomy and 2.6% for emergency laparotomy. The common risk factors identified were emergency laparotomy, age <30 years and age above 60 years and male sex. Low socio economic status was also a common cause of wound dehiscence. Hypertension and diabetes were present in some cases. Anaemia, hypoalbuminemia and kidney function derangement were also common among wound dehiscence patients. Another important finding was presence of malignancy. Wound infection, sepsis and raised intra abdominal pressure (coughing, vomiting) were also an important cause of abdominal wound dehiscence. Further studies with larger sample size and controlled studies were recommended to support this finding.