“Fascial dehiscence (FD), a serious complication of open surgical procedures, is regarded as a significant concern after abdominal surgeries. Its prevalence is reported to be 0.4–1.2% in elective laparotomies and up to 12% in emergency laparotomies. The mortality rate associated with it exceeds 21%. FD leads to an increase in hospitalization costs, prolonged hospital stays, a higher likelihood of re-operation, and an increase in subsequent
medical visits.
FD is described as the separation of sutured edges of the abdominal fascia following surgery. Four main mechanisms lead to FD, suture breakage, knot failure, suture loosening, or fascial disruption due to a hematoma. The latter is considered the most common. FD can be subclinical, and detectable only through radiology.”
able 1.
Frequency of studied variables in patients with and without fascia dehiscence.
| The group without fascia dehiscence (control group), n (%) | Group with fascia dehiscence (case group), n (%) | ||
|---|---|---|---|
| Variables | (n=40) | (n=20) | P |
| Age | |||
| 40–65 | 19 (47.5) | 14 (70) | 0.09 |
| 65–80 | 21 (52.2) | 6 (30) | |
| Sex | |||
| Male | 22 (55) | 11 (55) | 1 |
| Female | 18 (45) | 9 (45) | |
| CRP>10 at the beginning of hospitalization | 8 (20) | 3 (15) | 0.6 |
| Hb <10 (anemia) | 9 (22.5) | 3 (15) | 0.4 |
| Pr<6 | 1 (2.5) | 2 (10) | 0.2 |
| Smoking | |||
| Type of surgery | |||
| Elective | 22 (55) | 8 (40) | 0.2 |
| Emergency | 18 (45) | 12 (60) | |
| History of abdominal surgery | 8 (20) | 5 (25) | 0.6 |
| History of cancer | 20 (50) | 8 (40) | 0.4 |
| Chemotherapy, immunodeficiency and corten use | 10 (25) | 8 (40) | 0.2 |
| Pack cell injection before surgery | 10 (25) | 2 (10) | 0.1 |
| Death | 6 (15) | 14 (70) | <0.001 |
| Surgery more than 3 h | 4 (10) | 4 (20) | 0.2 |
| Bleeding more than 200 ml | 1 (2.5) | 2 (10) | 0.2 |
| history of diabetes | 5 (12.5) | 2 (10) | 0.7 |
| Chronic lung disease | 1 (2.5) | 1 (5) | 0.6 |
| Stoma | 10 (25) | 7 (35) | 0.4 |
| Drain installation | 16 (40) | 14 (70) | 0.02 |
| Anastomosis | 30 (75) | 12 (60) | 0.2 |
| Using stapler | 7 (17.5) | 6 (30) | 0.2 |
| Preoperative preparation | |||
| Yes | 22 (55) | 7 (35) | 0.14 |
| No | 18 (45) | 13 (65) | |
| Alb | |||
| 3> | 2 (5) | 13 (65) | <0.001 |
| 3< | 38 (95) | 7 (35) | |
| Type of surgery | |||
| Small intestine | 10 (25) | 5 (25) | 1 |
| Colon and rectom | 30 (75) | 15 (75) | |
Alb, albumin; CRP, C-reactive protein; Hb, hemoglobin; Pr, platelet count.
“Fascia dehiscence is more common among males aged 60–40 years and in emergency surgeries compared to elective procedures. It’s associated with higher mortality rates, lower
preoperative hemoglobin levels, and albumin levels less than 3. Patients with fascia dehiscence also showed increased CRP levels ost-occurrence. However, there’s no significant correlation between fascia dehiscence and various factors including age, sex,
anemia, type of surgery, preoperative preparation, surgical techniques, comorbidities, and lifestyle factors like smoking and protein intake. Based on the findings of this thesis and the results of related articles, it appears that fascia dehiscence may play a significant role in the mortality of patients after laparotomy surgeries. Therefore, conducting further research to find cost-effective solutions to prevent fascia dehiscence is recommended.”
Parsa, Hossein et al. “The evaluation of risk factors in fascia dehiscence after abdominal surgeries.” Annals of medicine and surgery (2012) vol. 86,9 4984-4989. 19 Jul. 2024, Free Full Text
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