Management of abdominal wound dehiscence at a tertiary care hospital
Author(s): Dr. AM Sreedhara and Dr. Padmanabha R Bhat
Abstract: There are two basic types of wound dehiscence, partial or complete, depending on the extent of separation. In partial dehiscence, only the superficial layers or part of the tissue layers reopen. In complete wound dehiscence, all layers of the wound thickness are separated, revealing the underlying tissue and organs, which may protrude out of the separated wound. This can be seen in some cases of abdominal wound dehiscence. A comprehensive study of these cases with keeping in record the date of admission, presenting complaints and general condition, risk factors, bold investigations, clinical diagnosis, the need for surgery and the types of surgery, followed by wound care, course in ward and day of dehiscence. Co-morbid conditions like anaemia, hypertension, diabetes mellitus, etc. were treated where possible. Initial dose of prophylactic intravenous antibiotics were given to all patients presenting with acute abdomen before surgery in emergency as well as elective cases, and course was continued with respect to requirements of every surgery. Out of 60 cases 28 patients had Hb% more than 10g/dl and 32 patients had Hb% less than 10g/dl. In the present study amongst 60 cases 2 patients had elevated hepatic enzymes. 36 patient had hypoalbuminemia. 4 patient had hyperbiluribinemia. Average stay was 18 which increases economic burden both on hospital and patients. There were 2 deaths. Mortality was mainly due to post-operative complication like septicaemia and respiratory tract infection.
