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Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study
BACKGROUND: Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients. METHODS: We performe...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Research and Publications Office of Jimma University
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188093/ https://www.ncbi.nlm.nih.gov/pubmed/34158758 http://dx.doi.org/10.4314/ejhs.v31i1.13 |
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author | Temesgen, Fisseha Gosaye, Abay Starr, Nichole Kiflu, Woubedil Getachew, Hana Dejene, Belachew Tadesse, Amezene Derbew, Miliard Negussie, Tihitena |
author_facet | Temesgen, Fisseha Gosaye, Abay Starr, Nichole Kiflu, Woubedil Getachew, Hana Dejene, Belachew Tadesse, Amezene Derbew, Miliard Negussie, Tihitena |
author_sort | Temesgen, Fisseha |
collection | PubMed |
description | BACKGROUND: Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients. METHODS: We performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher's exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes. RESULTS: Of 114 patients, median age was 46 months [range: 1day-13 years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96, p=0.003). Age (p=0.004) and malnutrition (p<0.001) were significantly associated with wound dehiscence. CONCLUSION: SSI and wound dehiscence are common in this setting. Wound contamination, antibiotics administration >1 hour before surgery and operative time >2 hours are independent predictors of SSI. |
format | Online Article Text |
id | pubmed-8188093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Research and Publications Office of Jimma University |
record_format | MEDLINE/PubMed |
spelling | pubmed-81880932021-06-21 Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study Temesgen, Fisseha Gosaye, Abay Starr, Nichole Kiflu, Woubedil Getachew, Hana Dejene, Belachew Tadesse, Amezene Derbew, Miliard Negussie, Tihitena Ethiop J Health Sci Original Article BACKGROUND: Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients. METHODS: We performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher's exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes. RESULTS: Of 114 patients, median age was 46 months [range: 1day-13 years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96, p=0.003). Age (p=0.004) and malnutrition (p<0.001) were significantly associated with wound dehiscence. CONCLUSION: SSI and wound dehiscence are common in this setting. Wound contamination, antibiotics administration >1 hour before surgery and operative time >2 hours are independent predictors of SSI. Research and Publications Office of Jimma University 2021-01 /pmc/articles/PMC8188093/ /pubmed/34158758 http://dx.doi.org/10.4314/ejhs.v31i1.13 Text en © 2021 Fisseha Temesgen, et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Temesgen, Fisseha Gosaye, Abay Starr, Nichole Kiflu, Woubedil Getachew, Hana Dejene, Belachew Tadesse, Amezene Derbew, Miliard Negussie, Tihitena Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title | Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title_full | Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title_fullStr | Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title_full_unstemmed | Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title_short | Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study |
title_sort | early outcome of laparotomy wounds in pediatric patients in tash, addis ababa, ethiopia: a six-months prospective study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188093/ https://www.ncbi.nlm.nih.gov/pubmed/34158758 http://dx.doi.org/10.4314/ejhs.v31i1.13 |
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