Abstract

Burst abdomen is post-operative separation of the Musculo-aponeurotic layers, including the peritoneum, with exposure of the intestines. Type of incision, vertical or transverse, nature of surgery, elective or emergency, and postoperative complications affect the outcome of Laparotomy. Objective: The study aims to find the etiological factors of burst abdomen and to find and evaluate effective management of abdominal wound dehiscence in elective and emergency Laparotomy and how to prevent and overcome its complications. This post-operative complication encountered by the surgeon is always a challenge. The main concern is because of the risk of evisceration and the need to intervene; there is always a possibility of recurrence of dehiscence. Material and Methods: Our study was conducted on 280 patients who had undergone exploratory laparotomy at MKCG MCH, BERHAMPUR, ODISHA. Of 280 patients, 136 underwent emergency laparotomy, and 144 were elective cases. They were managed either by midline vertical incision or transverse incision, and results were analysed for wound dehiscence. Result: Most significant variation associated with wound dehiscence was hypoproteinaemia, anaemia, chronic cough and emergency procedures. Pre-operative and post-operative etiological factors such as chronic cough, anaemia, hypoproteinaemia, diabetes, obesity, use of Steroids. Results concluded that male patients have higher incidence of laparotomy wound dehiscence and in fourth and fifth decade. Patients presented with peritonitis secondary to gastro-duodenal or ileal perforation are more prone to burst abdomen. Conclusion: Burst abdomen is a serious sequela of impaired wound healing. Incidence of burst abdomen is less in transverse incision in comparation to midline vertical incision.

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