Research article
Wound dehiscence: is still a problem in the 21th century: a retrospective study
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* Corresponding author: John Spiliotis jspil@in.gr
1 Department of Surgrery, Messologi General Hospital, Messologi, Greece
2 Department of Anesthesiology, Messologi General Hospital, Messologi, Greece
3 Intensive Care Unit, Arta General Hospital, Arta, Greece
World Journal of Emergency Surgery 2009, 4:12 doi:10.1186/1749-7922-4-12
Published: 3 April 2009Abstract
Background
The aim of this study was to evaluate the risk factors of wound dehiscence and determine which of them can be reverted.
Methods
We retrospectively analyzed 3500 laparotomies. Age over 75 years, diagnosis of cancer, chronic obstructive pulmonary disease, malnutrition, sepsis, obesity, anemia, diabetes, use of steroids, tobacco use and previous administration of chemotherapy or radiotherapy were identified as risk factors
Results
Fifteen of these patients developed wound dehiscence. Emergency laparotomy was performed in 9 of these patients. Patients who had more than 7 risk factors died.
Conclusion
It is important for the surgeon to know that wound healing demands oxygen consumption, normoglycemia and absence of toxic or septic factors, which reduces collagen synthesis and oxidative killing mechanisms of neutrophils. Also the type of abdominal closure may plays an important role. The tension free closure is recommended and a continuous closure is preferable. Preoperative assessment so as to identify and remove, if possible, these risk factors is essential, in order to minimize the incidence of wound dehiscence, which has a high death rate.