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2012 | 84 | 11 | 565-573
Tytuł artykułu

Risk Factors for Wound Dehiscence after Laparotomy – Clinical Control Trial

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Described in the literature dehiscence rate in the adult population is 0.3-3.5%, and in the elderly group as much as 10%. In about 20-45% evisceration becomes a significant risk factor of death in the perioperative period. The aim of the study was to identify the main risk factors for abdominal wound dehiscence in the adult population. Material and methods. The study included patients treated in the 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow in the period from January 2008 to December 2011, in which at that time laparotomy was performed and was complicated by wound dehiscence in the postoperative period. For each person in a research group, 3-4 control patient were selected. Selection criteria were corresponding age (± 2-3 years), gender, underlying disease and type of surgery performed. Results. In 56 patients (2.9%) dehiscence occurred in the postoperative period with 25% mortality. The group consisted of 37 men and 19 women with the mean age of 66.8 ± 12.6 years. Univariate analysis showed that chronic steroids use, surgical site infection, anastomotic dehiscence/fistula in the postoperative period and damage to the gastrointestinal tract are statistically significant risk factors for dehiscence. Two first of these factors occurred to be independent risk factors in the multivariate analysis. In addition, due to the selection criteria, a group of risk factors should also include male gender, emergency operation, midline laparotomy, colorectal syrgery and elderly age (> 65 years). Logistic regression analysis did not show that a particular surgeon, time of surgery or a particular month (including holiday months) were statistically significant risk factor for dehiscence. Conclusions. Wound dehiscence is a serious complication with relatively small incidence but also high mortality. Preoperative identification of risk factors allows for a more informed consent before patient’s treatment and to take measures to prevent or minimize the consequences of complication associated with it.
Słowa kluczowe
Wydawca

Rocznik
Tom
84
Numer
11
Strony
565-573
Opis fizyczny
Daty
wydano
2012-12-01
online
2013-02-09
Twórcy
autor
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
autor
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
autor
  • 3rd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
Bibliografia
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  • 8. Afzal S, Bahir mm: Determinants of Wound Dehiscence in Abdominal Surgery in Public Sector Hospital. Annals 2008; 14(3): 110-14.
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  • 10. Richards PC, Balch CM, Aldrete JS: Abdominal wound closure. A randomized prostpective study of 571 patients comparing continuous vs. interrupted suture techniques. Ann Surg 1970; 238: 1983-89.
  • 11. Van Ramshorst GH, Nieuwenhuizen J, HopWCJ: Abdominal Wound Dehiscence in Adults: Development and Validation of a Risk Model. WorldJ Surg 2010; 34: 20-27.
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  • 14. Pavlidis TE, Galatianos IN, Papaziogas BT et al.: Complete dehiscence of the abdominal wound and incriminating factors. Eur J Surg 2001; 167: 351-54.
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  • 16. Keill RH , Keitzer WF, Nichols WK et al.: Abdominal wound dehiscence. Arch Surg 1973; 106: 573-77.
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  • 18. Kihara A, Kasamaki S, Kamano T et al.: Abdominal wound dehiscence In patients receiving longterm steroid treatment. J Int Med Res 2006; 34(2): 223-30.[Crossref]
  • 19. Col C, Soran A, Col M: Can postoperative abdominal wound dehiscence be predicted? Tokai JExp Clin Med 1998; 23: 123-27.
  • 20. Riou JP, Cohen JR, Johnson H Jr.: Factors influencing wound dehiscence. Am J Surg 1992; 163: 324-30.
  • 21. Webster C, Neumayer L, Smout RE et al.: National Veterans Affairs Surgical Quality Improvement Program. Prognostic models of abdominal wound dehiscence after laparotomy. J Surg Res 2003; 109: 130-37.
  • 22. Papaziogas BT et al.: Complete dehiscence of the abdominal wound and incriminating factors. Eur J Surg 2001; 167: 351-54.
  • 23. Sowula A, Wermiński K, Groele H: Wytrzewienie a technika chirurgiczna. Pol Przegl Chir 2001; 73(5): 417-29.
  • 24. Gembal P, Grzegorczyk W, Grabowski B i wsp. Wiad Lek 2006; 59 (11-12): 767-71.
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Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-012-0094-0
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