Risk factors for wound dehiscence:
(1) hypoalbuminemia (< 3.5 g/dL)
(2) anemia (hemoglobin < 11 g/dL)
(3) malnutrition (hypoalbuminemia and weight loss > 5 kg during past 6 months)
(4) chronic lung disease
(5) emergency surgery
Post-operative risk factors:
(6) vomiting
(7) prolonged intestinal paralysis (ileus)
(8) repeated urinary retention
(9) increased coughing
Factors found not to be "significant" for predicting dehiscence:
(1) obesity
(2) chronic heart disease
(3) diabetes mellitus
(4) alcoholism
(5) preoperative intestinal obstruction
(6) jaundice
(7) local or systemic infection
(8) steroid use
(9) type of incision
(10) operating time
(11) type of wound closure
number of risk factors =
= SUM(risk factors present)
|
Number of Preoperative Risk Factors
|
Percent Wound Dehiscence
|
|
0
|
17% (small number)
|
|
1
|
19%
|
|
2
|
29%
|
|
3
|
58%
|
|
>= 4
|
78%
|
Interpretation:
• The number of wound dehiscences increased as the number of risk factors increased.
• Internal retention sutures were recommended for patients with 3 or more risk factors prior to surgery.
