Online ISSN: 2515-8260

Keywords : Wound infection


A Study to Observe the Cases of Abdominal Wound Dehiscence in Patients Undergoing Emergency Laparotomy with Midline Incision

Dr. Amuleek Kaur, Dr. Karaninder Singh Wilku,Dr. Gopal Swaroop Bhargava,Dr. Ajaypal Singh Sandhu .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 79-86

Aim: A study to observe the cases of abdominal wound dehiscence in patients undergoing emergency laparotomy with midline incision.
Objectives: To calculate the frequency of abdominal wound dehiscence in patients undergoing emergency laparotomies subjected to midline incision and to determine hypoproteinemia, anemia and surgical site infection as contributing factors for abdominal wound dehiscence in emergency laparotomies with midline incision.
Materials and Methods: Observational cohort study carried out in the department of General Surgery at Sri Guru Ram Das University of Health Sciences, Vallah, Sri Amritsar on 60 patients who underwent emergency laparotomy with midline incision.
Results: In our study, patients belonging to various kinds of age group and socio economic background were included in the study irrespective of the gender. Amongst the 60 patients included, abdominal wound dehiscence was seen in 36 patients corresponding to 60% of the sample size. This study was endeavoured to delineate the role of anemia, hypoalbuminaemia and SSI (surgical site infection) in the dehiscence seen in these patients and it was observed that majority of the patients undergoing abdominal wound dehiscence had hypoalbuminaemia thus, making it the most significant risk factor followed by anemia and surgical site infection.
Conclusion: In this study we concluded that Abdominal wound dehiscence is a serious sequel of impaired wound healing. Many factors can predispose to this grave complication of which anemia, hypoproteinaemia and surgical site infection carry enormous significance. Patients with these risk factors require more attention and special care to minimize the risk of occurrence. Postoperative abdominal wound dehiscence can be prevented by improving the nutritional status of the patient, strict aseptic precautions, optimization of patient's hemodynamic losses and by proper surgical technique. Early diagnosis of burst abdomen and aggressive treatment helps in reducing morbidity and mortality. Some of the major factors like the ones mentioned in this study must be vigilantly looked for and treated to prevent this catastrophic complication.

Effect of Various Co-Morbidities on Abdominal Wound Dehiscence after Midline Laparotomy

Venkatesham B

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 960-967

Background: Wound dehiscence is defined as separation of all layers of incision. It may
be partial or complete. Partial when one or more layers have separated but either the
skin or the peritoneum is intact. Complete when all layers of the abdominal wall have
opened apart and this may or may not be associated with evisceration of viscus. The
study aimed to find out and record the etiological factors for Burst abdomen.
Materials and Methods: This study was prospective, randomized and comparative
study conducted on 120 patients undergoing midline laparotomy in the Department of
General Surgery, Kalinga Institute of Medical Sciences over a period of 1 year. Patients
were selected who require midline laparotomy either as emergency or elective
procedure. 120 patients who were divided into two groups 60 each by sealed envelope
method and they were randomized into Group 1 and Group 2. The patients in Group 1
underwent closure of rectus sheath with conventional continuous closure technique and
in Group 2 underwent closure with interrupted X suture technique. A total of 60
patients were included in each group.
Results: In this study, there were 44% males and 15% females in Group -1 while there
were 49% males and 12% females in Group 2. In group 1, mean age was 48.03 years
and SD ± 16.15. In group 2, mean age was 46.44 years and SD ± 15.68 In Group 1, out of
60 patients wound dehiscence occurred in 22 cases while in Group 2, out of 60 patients
wound dehiscence occurred in 9 cases. In Group 1, 17 patients were anemic, 5 patients
were diabetics, 18 patients had uremia, 44 patients had hypoalbuminemia and 49
patients had chest infection. In Group 2, 11 patients were anemic, 7 patients were
diabetics, 17 patients had uremia, 41 patients had hypo‌albuminemia and 34 patients
had chest infection.

A Comparative Study Between Open and Laparoscopic Cholecystectomy

Srikanth Jukuru

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1217-1225

Background: The aim of this study is to compare conventional cholecystectomy and
laparoscopic cholecystectomy.
Materials and Methods: The study subjects consisted of 40 patients with a diagnosis of
calculous cholecystitis that underwent cholecystectomy at Bhaskar Medical College and
General Hospital, yenkapally from January 2018 to June 2019. The patients will be
evaluated for detailed clinical history according to a definite proforma. All the patients
will be examined and routine blood investigations with LFT wherever necessary will be
done. Abdominal USG will be performed in all the cases.
Results: The commonest presenting complaint in both the groups was pain in the right
upper quadrant followed by vomiting, fever and dyspepsia. Majority of the patients in
both the groups had multiple stones. (15 patients in LC group and 14 patients in OC
group) The duration of LC was significantly more than for OC (median 105 min v/s
75min respectively). The intra operative blood loss and the complications were more for
the open procedure. Two patients of laparoscopic group required conversion to open
procedure. The drains were required in less number of patients of LC group and for
less number of days. Wound infection was seen in 1 of LC patient and 5 of OC patients.
One patient of OC group developed incisional hernia. The antibiotic requirement was
less in LC group (median 5days) compared to OC group (median 7days). The Visual
Analogue Scale for pain in the post op period was significantly less for LC patients
compared to OC patients (median Grade1 v/s Grade3 respectively). The duration of
pain in the LC group was significantly less (median of 2 days) compared to OC group
(median of 4 days). The analgesic requirement was significantly less in LC patients
(median for3days) compared to OC patients (median for 5 days). The LC patients
tolerated oral feeds earlier compared to OC patients (6- 8hours compared to 12-36
hours respectively). The duration of hospital stay was significantly longer for OC group
than for LC group (median 7 days versus 4 days respectively). The time to return to
normal work was delayed for OC group (median 8 days) compared to LC group
(median 5 days). The cosmetic end result was unacceptable in majority of OC patients
(14 of 20). While majority of LC patients were satisfied with the operative scar (16 of
20).
Conclusion: The laparoscopic procedure was costly compared to open procedure. But
this difference was overcome by the other costs incurred in post-operative period of
open procedure.