A prospective evaluation of the risk factors for wound dehiscence and incisional hernia development
Kerim Bora Yılmaz1, Melih Akıncı1, Lütfi Doğan2, Niyazi Karaman2, Cihangir Özaslan2, Can Atalay2
1Department of General Surgery, Dışkapı Training Hospital, Ankara, Turkey
2Department of General Surgery, Ankara Oncology Training Hospital, Ankara, Turkey
Objective: Post-laparotomy wound dehiscence, evantration and evisceration are important complications leading to higher morbidity and mortality. Incisional hernias are frequently observed following abdominal surgeries and their occurrence is related with various local and systemic factors. This study aims to analyze the factors affecting wound healing by investigating the parameters that may cause wound dehiscence, incisional hernia, sinus formation and chronic incisional pain.
Material and Methods: The records of 265 major abdominal surgery patients were analyzed. The data on patient characteristics, medication, operation procedure type, suture types, surgical instruments and complications were recorded. The patients were followed with respect to sinus formation, incisional hernia occurrence and chronic incision pain. Statistical analysis was performed using SPSS 10.00 program. The groups were compared via chi-square tests. Significance was determined for p<0.05. Multi-faceted analysis was evaluated with forward logistic regression analysis.
Results: Of all the patients, 115 (43.4%) were female and 150 (56.6%) were male. Ninety-four (35.5%) patients were under 50 years old and 171 (64.5%) were over 50 years old. Median follow-up period was 28 months (0-48). Factors affecting the wound dehiscence were found to be; ostomy creation (p=0.002), postoperative pulmonary problems (p=0.001) and wound infection (p=0.001). Factors leading to incisional hernia are; incision type (p=0.002), ostomy creation (p=0.002), postoperative ileus (p=0.027), postoperative pulmonary problems (p=0.017) and wound infection (p=0.011).
Conclusion: Learning about the factors causing wound dehiscence and incisional hernia, intervention of risk factors and taking relevant measures may prevent complications. In particular, surgical complications that occur in the postoperative period are linked to wound dehiscence problems.
Keywords: Abdominal surgery, wound dehiscence, incisional hernia, sinus formation, chronic incision pain
Study concept and design - K.B.Y., C.Ö., C.A.; Acquisition of data - K.B.Y., L.D., N.K.; Analysis and interpretation of data - M.A., K.B.Y.; Preparation of the manuscript - K.B.Y., M.A.; Statistical analysis - K.B.Y., C.A., C.Ö.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.