The evaluation of risk factors in fascia dehiscence after abdominal surgeries

“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
 40–6519 (47.5)14 (70)0.09
 65–8021 (52.2)6 (30)
Sex
 Male22 (55)11 (55)1
 Female18 (45)9 (45)
CRP>10 at the beginning of hospitalization8 (20)3 (15)0.6
Hb <10 (anemia)9 (22.5)3 (15)0.4
Pr<61 (2.5)2 (10)0.2
Smoking
 Type of surgery
  Elective22 (55)8 (40)0.2
  Emergency18 (45)12 (60)
History of abdominal surgery8 (20)5 (25)0.6
History of cancer20 (50)8 (40)0.4
Chemotherapy, immunodeficiency and corten use10 (25)8 (40)0.2
Pack cell injection before surgery10 (25)2 (10)0.1
Death6 (15)14 (70)<0.001
Surgery more than 3 h4 (10)4 (20)0.2
Bleeding more than 200 ml1 (2.5)2 (10)0.2
history of diabetes5 (12.5)2 (10)0.7
Chronic lung disease1 (2.5)1 (5)0.6
Stoma10 (25)7 (35)0.4
Drain installation16 (40)14 (70)0.02
Anastomosis30 (75)12 (60)0.2
Using stapler7 (17.5)6 (30)0.2
Preoperative preparation
 Yes22 (55)7 (35)0.14
 No18 (45)13 (65)
Alb
 3>2 (5)13 (65)<0.001
 3<38 (95)7 (35)
Type of surgery
 Small intestine10 (25)5 (25)1
 Colon and rectom30 (75)15 (75)

Alb, albumin; CRP, C-reactive protein; Hb, hemoglobin; Pr, platelet count.

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