Determinants of Abdominal Wound Dehiscence: A Case-Control Study

Abstract

Background

Abdominal wound dehiscence (AWD) is a serious postoperative complication. It is a mechanical failure of a healing abdominal surgical wound. The incidence of abdominal wound dehiscence ranges from 0.4 to 3.5%, and it can reach 10% in the elderly. Despite advances made over the past decades in perioperative care and suture materials, incidence and mortality rates of abdominal wound dehiscence have not changed markedly.

Objectives

The purpose of this investigation was to determine the magnitude and predictors of abdominal wound dehiscence in patients who underwent laparotomy at two hospitals in Sidama regional state, Ethiopia, in 2023.

Methods

We employed a case-control study design to determine the magnitude and implicated risk factors of abdominal wound dehiscence among pediatric and adult patients who underwent laparotomy for various indications between April 1, 2018 and January 31, 2023 at Hawassa University Comprehensive Specialized Hospital and Yirgalem hospital medical college. We analyzed a sample size of 196 patients (63 cases and 133 controls). Using the Kobo toolbox, data were captured from the operation theater log book and chart review and exported to SPSS version 26 for analysis. The results of descriptive and analytical analyses were presented using tables, graphs, and charts.

Results

The extent of abdominal wound dehiscence was determined to be 1.66%. Place of residence, AOR = 13.94 (95% CI: 3.57-54.45), post-operative complications, AOR = 20.40 (95% CI:6.79-61.25), anemia, AOR = 4.01 (95% CI: 1.32-12.17), and emergency surgery, AOR = 10.17 (95% CI:2.28-45.25), were all statistically significant

Conclusion

We propose that special attention be paid to those from rural areas and those who undergo emergency surgery. Preventing postoperative complications and addressing the root cause of anemia as much as possible is critical.