Study on wound healing following major abdominal gynaecological surgeries in a tertiary care hospital

Sandhyasree Panda; Madhavi Uppala

doi:10.18203/2320-1770.ijrcog20231213

Authors

Sandhyasree Panda Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences, Vizianagaram, Andhra Pradesh, India
Madhavi Uppala Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences, Vizianagaram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231213

Keywords:

Abdominal gynaecological surgeries, Postoperative hospital stay, Surgical site infection, Wound healing, Wound dehiscence

Abstract

Background: In the fancy era of minimal invasive, day care and scarless surgery, abdominal operation through a laparotomy is but a last choice for the mediocre. Surgical site wound healing is a benchmark for patient as well as surgeon satisfaction following an abdominal operation. It is a determinant of preop preparation, intra and post op management by the healthcare system and the duration of hospital stay as well as burden of disease. Aim of the study was to study the spectrum wound healing, and post operative hospital stay in patients undergoing major gynaecological abdominal surgeries. To assess and correlate the underlying risk factors for wound healing.

Methods: This was a hospital based prospective study carried out in a tertiary care centre in north A.P. on patients who underwent major abdominal gynaecological surgeries during one year from January 2022 to December 2022. Determinants like patient age, BMI, anaemia, HTN, Diabetes mellitus, hypothyroidism were studied & made observations on wound healing, SSIs and post operative hospital stay in all the cases. Statistical analysis was done using SPSS version 22, P value <0.05 taken as significant.

Results: Among 100 major abdominal gynaecological surgeries studied, 20 cases developed delayed wound healing, one case developed complete dehiscence, thus, incidence of wound dehiscence was 1%, rate of SSI was 12%. Anaemia, DM, obesity and HTN were significantly associated with poor wound healing in that order.

Conclusions: Optimisation of the patient’s health condition before taking up for elective surgeries is important for better recovery of the patients.

Metrics

Metrics Loading ...

References

Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing: a cellular perspective. Physiological Reviews. 2019 Jan 1;99(1):665-706.

Guo SA, DiPietro LA. Factors affecting wound healing. J Dental Res. 2010;89(3):219-29.

Wernick B, Nahirniak P, Stawicki SP. Impaired wound healing. StatPearls. 2021.

Shanmugam VK, Fernandez SJ, Evans KK, McNish S, Banerjee AN, Couch KS. Postoperative wound dehiscence: predictors and associations. Wound Repair Reg. 2015;23(2):184-90.

Hess CT. Checklist for factors affecting wound healing. Advances in skin and wound care. 2011;24(4):192.

Stechmiller JK. Understanding the role of nutrition and wound healing. Nutrition in clinical practice. 2010;25(1):61-8.

Okonkwo UA, DiPietro LA. Diabetes, and wound angiogenesis. Int J Molecular Sci. 2017;18(7):1419.

Ahmed AA, Mooar PA, Kleiner M, Torg JS, Miyamoto CT. Hypertensive patients show delayed wound healing following total hip arthroplasty. PLoS One. 2011;6(8):e23224.

Pierpont YN, Dinh TP, Salas RE, Johnson EL, Wright TG, Robson MC, et al. Obesity and surgical wound healing: a current review. Int Scholarly Res Notices. 2014;2014.

Esendagli G, Yoyen-Ermis D, Guseinov E, Aras C, Aydin C, Uner A, Hamaloglu E, et al. Impact of repeated abdominal surgery on wound healing and myeloid cell dynamics. J Surg Res. 2018;223:188-97.

Aga E, Keinan-Boker L, Eithan A, Mais T, Rabinovich A, Nassar F. Surgical site infections after abdominal surgery: incidence and risk factors. A prospective cohort study. Infect Dis. 2015;47(11):761-7.

Narang R, Nandmer GK, Sapkal R. Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries. Int J Repro Contraception Obst Gynecol. 2017;6(4):1530-4.

Metgud MC, Kataria A, Nadipally SR, Patil K. Incidence of wound dehiscence following obstetric and gynecological surgeries at a Tertiary Care Hospital: a retrospective study. J South Asian Fed Obst Gynaecol. 2020;12(2):73-8.

Pierpont YN, Dinh TP, Salas RE, Johnson EL, Wright TG, Robson MC, et al. Obesity and surgical wound healing: a current review. Int Scholarly Res Notices. 2014;2014.

Sonwani B, Singh KK, Meshram S. Anaemia in surgical patients and its effect on recovery of patients. Int Surg J. 2016;3(1):71-6.

Metgud MC, Kataria A, Nadipally SR, Patil K. Incidence of wound dehiscence following obstetric and gynecological surgeries at a Tertiary Care Hospital: a retrospective study. J South Asian Fed Obst Gynaecol. 2020;12(2):73-8.

Maqsood R, Ans M, Malhi AA, Mahmood K, Afzal H, Zulfiqar U. Wound complications due to diabetes in patients undergoing abdominal surgery. Pakistan Armed Forces Med J. 2020;70(1):3-7.

Rosko AJ, Birkeland AC, Bellile E, Kovatch KJ, Miller AL, Jaffe CC, et al. Hypothyroidism and wound healing after salvage laryngectomy. Annals Surg Oncol. 2018;25:1288-95.

Esendagli G, Yoyen-Ermis D, Guseinov E, Aras C, Aydin C, Uner A, et al. Impact of repeated abdominal surgery on wound healing and myeloid cell dynamics. J Surg Res. 2018;223:188-97.

Aga E, Keinan-Boker L, Eithan A, Mais T, Rabinovich A, Nassar F. Surgical site infections after abdominal surgery: incidence and risk factors. A prospective cohort studies. Infect Dis. 2015;47(11):761-7.

Borle FR. Determinants of superficial surgical site infections in abdominal surgeries at a Rural Teaching Hospital in Central India: a prospective study. J Family Medicine Primary Care. 2019;8(7):2258.

Taylor GD, Kirkland TA, McKenzie MM, Sutherland B, Wiens RM. The effect of surgical wound infection on postoperative hospital stays. Canadian J Surg. 1995;38(2):149.