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Retrospective review of risk factors for surgical wound dehiscence and incisional hernia

Journal article
Authors Sofie Walming
Eva Angenete
Mattias Block
David Bock
Bodil Gessler
Eva Haglind
Published in Bmc Surgery
Volume 17
Issue 1
ISSN 1471-2482
Publication year 2017
Published at Institute of Clinical Sciences, Department of Surgery
Language en
Links dx.doi.org/10.1186/s12893-017-0207-...
Keywords Hernia, Laparotomy, Risk factors, Surgical wound dehiscence, major gastrointestinal operations, aortic reconstructive surgery, midline laparotomy, suture technique, length ratio, closure, complications, trial, Surgery
Subject categories Gastroenterology and Hepatology

Abstract

Background: Several factors and patient characteristics influence the risk of surgical wound dehiscence and incisional hernia after midline laparotomy. The purpose of this study was to investigate whether a specified, or not specified, suture quota in the operative report affects the incidence of surgical wound complications and to describe the previously known risk factors for these complications. Methods: Retrospective data collection from medical records of all vascular procedures and laparotomies engaging the small intestines, colon and rectum performed in 2010. Patients were enrolled from four hospitals in the region Vastra Gotaland, Sweden. Unadjusted and adjusted Cox regression analyses were used when calculating the impact of the risk factors for surgical wound dehiscence and incisional hernia. Results: A total of 1,621 patients were included in the study. Wound infection was a risk factor for both wound dehiscence and incisional hernia. BMI 25-30, 30-35 and > 35 were risk factors for wound dehiscence and BMI 30-35 was a risk factor for incisional hernia. We did not find that documentation of the details of suture technique, regarding wound and suture length, influenced the rate of wound dehiscence or incisional hernia. Conclusions: These results support previous findings identifying wound infection and high BMI as risk factors for both wound dehiscence and incisional hernia. Our study indicates the importance of preventive measures against wound infection and a preoperative dietary regiment could be considered as a routine worth testing for patients with high BMI planned for abdominal surgical precedures.

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