Col et al evaluated risk factors associated with postoperative abdominal wound dehiscence. This is a serious complication associated with prolonged hospital stays, increased health care costs, and increased mortality. Patients identified as being high risk may benefit from close observation and early intervention. The authors are from the Ankara Numune Teaching Hospital in Turkey.


Factors associated with an increased risk of wound dehiscence:

(1) hypoproteinemia (associated with low serum albumin)

(2) nausea and vomiting (more than 2 times per day, or requiring treatment)

(3) fever (more than 38°C in 2 consecutive readings)

(4) wound infection

(5) abdominal distention

(6) type of suture material (see Table 6, page 125): silk suture was higher risk, while continuous polidiaxonone (PDS) was low risk

(7) >= 2 abdominal drains

(8) surgeon's experience, with risk low for senior surgeons


Factors NOT associated with an increased risk of wound dehiscence:

(1) emergency surgery

(2) jaundice

(3) ostomy

(4) total parenteral nutrition

(5) ascites

(6) pulmonary morbidity

(7) comorbid disease (atherosclerosis, diabetes mellitus, hypertension, chronic renal disease, COPD, heart failure, other)

(8) anemia

(9) leukocytosis

(10) type of incision



• The risk of wound dehiscence when all 8 risk factors are present is 100%.

• The risk of wound dehiscence when none of the risk factors is present is low.

• Unfortunately the risks when 1-7 factors is present is not explicitly stated.

• Mortality increased as the total number of risk factors increased. This appears to be include both factors associated and not associated with wound dehiscence (mortality 30% with 7 risk factors, 58% with 8, and 100% for >= 10).


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