Waqar S H, Malik Zafar Iqbal, Razzaq Asma, Abdullah M Tariq, Shaima Aliya, Zahid M A
Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad.
J Ayub Med Coll Abbottabad. 2005 Oct-Dec;17(4):70-3.
Wound dehiscence/burst abdomen is a very serious postoperative complication associated with high morbidity and mortality. It has significant impact on health care cost, both for the patients and hospitals. The aim of the study was to determine the frequency of wound dehiscence/burst abdomen in patients undergoing emergency and elective laparotomies through midline incisions and to identify the risk factors for wound dehiscence.
This study was carried out at department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from 1st January 2002 to 31st December 2002. 117 consecutive patients undergoing laparotomy with midline incision were included. They were followed by wound examination from third postoperative day onwards to see their normal or otherwise healing.
Seven out of 117 (5.9%) patients developed wound dehiscence. Five of them (4.2%) were operated in emergency and two (1.7%) were operated on elective list.
It is very clear from our study that frequency of wound dehiscence/burst abdomen is still very high in our hospital. Peritonitis, wound infection and failure to close the abdominal wall properly are most important causes of wound dehiscence. Malnourishment and malignant obstructive jaundice predispose a patient to wound dehiscence by slowing the healing, and increasing rate of wound infection.
伤口裂开/腹壁破裂是一种非常严重的术后并发症，与高发病率和死亡率相关。它对患者和医院的医疗保健成本都有重大影响。本研究的目的是确定经中线切口进行急诊和择期剖腹手术患者的伤口裂开/腹壁破裂发生率，并确定伤口裂开的危险因素。
本研究于2002年1月1日至2002年12月31日在伊斯兰堡巴基斯坦医学科学研究所普通外科进行。纳入117例连续接受中线切口剖腹手术的患者。从术后第三天开始对他们进行伤口检查，观察伤口是否正常愈合。
117例患者中有7例（5.9%）发生伤口裂开。其中5例（4.2%）为急诊手术，2例（1.7%）为择期手术。
从我们的研究中可以非常清楚地看出，我院伤口裂开/腹壁破裂的发生率仍然很高。腹膜炎、伤口感染和腹壁关闭不当是伤口裂开的最重要原因。营养不良和恶性梗阻性黄疸会因延缓愈合和增加伤口感染率而使患者易发生伤口裂开。
