Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy.

IF 1.5 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2024-08-01 Epub Date: 2023-10-10 DOI:10.1055/s-0043-1771223

Tina B S Miholjcic, Olivier Baud, Pouya Iranmanesh, Barbara E Wildhaber

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引用次数: 0

Abstract

Background: Surgical wound dehiscence (SWD) in neonates is a life-threatening complication. The aim was to define risk factors of postoperative incision dehiscence in this population.

Methods: Data of 144 patients from 2010 to 2020 were analyzed retrospectively. All full-term newborns or preterm newborns up to 42 weeks of amenorrhea (adjusted) who had a laparotomy within 30 days were included. Descriptive patient information and perioperative data were collected. SWD was defined as any separation of cutaneous edges of postoperative wounds.

Results: Overall, SWD occurred in 16/144 (11%) patients, with a significantly increased incidence in preterm newborns (13/59, 22%) compared with full-term newborns (3/85, 4%; p < 0.001). SWD was significantly associated with exposure to postnatal steroids (60% vs. 4%, p < 0.001) and nonsteroidal anti-inflammatory drugs (25% vs. 4%, p < 0.01), invasive ventilation duration before surgery (median at 10 vs. 0 days, p < 0.001), preoperative low hemoglobin concentration (115 vs. 147 g/L, p < 0.001) and platelet counts (127 vs. 295 G/L, p < 0.001), nonabsorbable suture material (43% vs. 8%, p < 0.001), the presence of ostomies (69% vs. 18%, p < 0.001), positive bacteriological wound cultures (50% vs. 6%, p < 0.001), and relaparotomy (25% vs. 3%, p < 0.01). Thirteen of 16 patients with SWD presented necrotizing enterocolitis/intestinal perforations (81%, p < 0.001).

Conclusion: This study identified prematurity and a number of other factors linked to the child's general condition as risk factors for SWD. Some of these can help physicians recognize and respond to at-risk patients and provide better counseling for parents.

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新生儿剖腹产术后切口脱落的危险因素。

背景：新生儿手术伤口裂开（SWD）是一种危及生命的并发症。目的是确定该人群术后切口裂开的危险因素。方法：对2010年至2020年144名患者的数据进行回顾性分析。包括所有在30天内进行剖腹手术的闭经（调整后）42周以内的足月新生儿或早产新生儿。收集描述性患者信息和围手术期数据。SWD被定义为术后伤口皮肤边缘的任何分离。结果：总的来说，SWD发生在16/144（11%）的患者中，与足月新生儿（3/85，4%；p p p p p p p p p p p 结论：这项研究确定早产和其他一些与儿童一般状况相关的因素是SWD的风险因素。其中一些可以帮助医生识别和应对高危患者，并为父母提供更好的咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.