Murugavel Japhereena, Vajiravelu Thirunavukkarasu Arasu, Gnana Chellaiyan Vinoth, Sridharan Vijayalakshmi
Department of General Surgery, Government Peripheral Hospital, Stanley Medical College, Chennai, IND.
Department of General Surgery, Chengalpattu Medical College, Chengalpattu, IND.
Cureus. 2024 May 4;16(5):e59642. doi: 10.7759/cureus.59642. eCollection 2024 May.
Introduction The ideal abdominal wound closure provides strength and a barrier to infection. The major cause of morbidity following any laparotomy is abdominal wound dehiscence. For prompt patient recovery and outcome factors influencing wound healing following mass closure of post-laparotomy, wound dehiscence patients are evaluated in this present study. The aim of the study was to evaluate the outcome and various complications following mass closure of post-laparotomy wound dehiscence. Materials and methods A prospective study was conducted among 50 patients admitted to the Department of General Surgery, Tamil Nadu, India, with wound dehiscence following emergency and elective laparotomy surgeries managed with mass closure during the study period from 2021 to 2022. The chi-square test and Fischer's exact test were done. Results Mass closure of post-laparotomy wound dehiscence was more common among males (74%, n=37) and less common in the age group 20-30 years (12%, n=6). Prolonged bleeding time and clotting time post-surgery were associated with the type of surgery with a significant p-value of 0.007 and 0.001, respectively, by Fischer's exact test. The presence of urine albumin was also associated with the type of surgery with a significant p-value of 0.02. Surgical site infection (postoperative complication) was associated with the type of surgery and operating time with a significant p-value of 0.004 and 0.03, respectively. Conclusion Abdominal wound dehiscence is a serious and challenging postoperative complication that necessitates immediate intervention. Strict postoperative care places emphasis on reducing the risk of wound infection and other factors related to wound dehiscence.
引言 理想的腹部伤口缝合应具备强度并能防止感染。任何剖腹手术后发病的主要原因是腹部伤口裂开。为了促进患者快速康复以及了解影响剖腹手术后大量伤口缝合后伤口愈合的结果因素,本研究对伤口裂开患者进行了评估。本研究的目的是评估剖腹手术后伤口裂开大量缝合后的结果及各种并发症。
材料与方法 对2021年至2022年研究期间在印度泰米尔纳德邦普通外科收治的50例因急诊和择期剖腹手术导致伤口裂开并采用大量缝合治疗的患者进行了前瞻性研究。进行了卡方检验和费舍尔精确检验。
结果 剖腹手术后伤口裂开的大量缝合在男性中更为常见(74%,n = 37),在20 - 30岁年龄组中较少见(12%,n = 6)。费舍尔精确检验显示,术后出血时间延长和凝血时间延长分别与手术类型相关,p值分别为0.007和0.001,具有显著性。尿白蛋白的存在也与手术类型相关,p值为0.02,具有显著性。手术部位感染(术后并发症)与手术类型和手术时间相关,p值分别为0.004和0.03,具有显著性。
结论 腹部伤口裂开是一种严重且具有挑战性的术后并发症,需要立即干预。严格的术后护理重点在于降低伤口感染风险及其他与伤口裂开相关的因素。