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CC BY-NC-ND 4.0 · Eur J Pediatr Surg 2024; 34(04): 351-362
DOI: 10.1055/s-0043-1771223
Original Article

Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy

Tina B. S. Miholjcic
1   Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
2   Faculty of Medicine, University of Geneva, Geneva, Switzerland
,
Olivier Baud
2   Faculty of Medicine, University of Geneva, Geneva, Switzerland
3   Division of Neonatal and Pediatric Intensive Care, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
,
Pouya Iranmanesh
2   Faculty of Medicine, University of Geneva, Geneva, Switzerland
4   Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
,
Barbara E. Wildhaber
1   Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
2   Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Funding None.
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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.

Keywords

wound dehiscence - surgical incision - neonate - preterm newborns - full-term newborns

Author Contributions

Study conception and design: BEW, TBSM. Data acquisition: TBSM. Analysis and data interpretation: TBSM, BEW. Drafting of the manuscript: TBSM, BEW. Critical revision: PI, OB.




Publikationsverlauf

Eingereicht: 18. März 2023

Angenommen: 26. Mai 2023

Artikel online veröffentlicht:
10. Oktober 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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