Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 11 , ISSUE 5 ( September-October, 2019 ) > List of Articles

CASE REPORT

Recurrent Abdominal Burst after Obstetric Surgical Procedure

Noor A Zulhijayanti, Rozi A Aryananda, Lynda Hariani, Eko B Koendhori, Ernawati Darmawan

Keywords : Obstetric surgical procedure, Recurrent abdominal burst, Vacuum-assisted closure

Citation Information : Zulhijayanti NA, Aryananda RA, Hariani L, Koendhori EB, Darmawan E. Recurrent Abdominal Burst after Obstetric Surgical Procedure. J South Asian Feder Obs Gynae 2019; 11 (5):321-328.

DOI: 10.5005/jp-journals-10006-1715

License: CC BY-NC 4.0

Published Online: 18-07-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Introduction: Abdominal burst due to obstetric surgery complications is still a concern because it increases maternal morbidity and mortality. Case description: There are 15 cases with abdominal burst obtained from 3,914 obstetric surgical procedures during 2013 to 2018 in Dr Soetomo General Hospital, with 5 cases (30%) of recurrent abdominal bursts. Preoperative risk factors are obtained from the host, such as anemia, hypoalbuminemia, and autoimmune diseases. Two recurrent abdominal burst cases occurred after cesarean section, and three cases occurred in hysterectomy after cesarean section, all of which used retention sutures as initial management, and in reality, it did not prevent repeated bursts. The whole case went to emergency surgery, and surgical site infection was obtained as an agent that aggravates the degree of disease. Selection of management and treatment is based on the patient's wound problems. Two cases required intensive and multidisciplinary care and used vacuum-assisted closure (VAC) and modified VAC. There were two patients (6.7%) who died from sepsis, while three other patients had well-closed wounds, and no complications have been found to date. Conclusion: One-third of abdominal burst patients in Dr Soetomo General Hospital had recurrence involving long-term multidisciplinary care and required facilities and an optimal environment. The dominant risk factors are obtained from the inferior conditions of the host, such as anemia, hypoalbuminemia, and autoimmune diseases.


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  1. Dare FO, Bako AU, Ezechi OC. Abdominal burst following caesarean section: A preventable surgical complication. J Obstet Gynaecol 2000;20(6):612–613. DOI: 10.1080/01443610020001468.
  2. Parmar G, Gohil A, Hathila V. Abdominal burst – A grave postoperative complication. The Int J Surg 2008;20(1):1–9.
  3. Mahey R, Ghetla S, Rajpurohit J, et al. A prospective study of risk factors for abdominal wound dehiscence. Int Surg J 2017;4(1):24–28. DOI: 10.18203/2349-2902.isj20163983.
  4. Wagner MS, Bedard MJ. Postpartum uterine wound dehiscence: A case report. J Obstet Gynaecol Can 2006;28(8):713–715. DOI: 10.1016/S1701-2163(16)32236-8.
  5. Schein M, Rogers P. Schein's Common Sense Emergency Abdominal Surgery. New York: Springer Link; 2004.
  6. Soni P, DayspriYes VB, DayspriYes A, et al. Abdominal burst: A post-operative morbidity. Int J Sci Stu 2015;3(6):175–178. DOI: 10.17354/ijss/2015/417.
  7. Burger JWA, Incisional Hernia: Etiology, Prevention, Treatment. Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam; 2006.
  8. Spiliotis J, Tsiveriotis K, Datsis A, et al. Wound dehiscence is still a problem in the 21th century: A retrospective study. World J Emerg Surg 2009;4(12):1–5. DOI: 10.1186/1749-7922-4-12.
  9. Amini AQ, Khan NA, Ahmad J, et al. Management of abdominal wound dehiscence: Still a challenge. Pak J Surg 2013;29:84–87.
  10. Singh Ahi K, Khandekar SM, Mittal SK, et al. Prevention of abdominal burst by interrupted closure: a comparative study of conventional continuous versus interrupted-X-type versus Hughes far-and-near interrupted abdominal Fascial closure in surgical patients. IOSR Journal of Dent Med Sci (IOSR-JDMS) 2017;16(2):21–30. DOI: 10.9790/0853-1602072130, Ver. VII.
  11. Gislason H, Viste A. Closure of abdominal burst after major gastrointestinal operations: comparison of different surgical techniques and later development of incisional hernia. Our J Surg 1999;165:958–961.
  12. Shukla HS, Kumar S, Misra MC, et al. Abdominal burst and suture material: a comparison of abdominal wound closure with monofilament nylon and chromic catgut. Indian J Surg 1981;43:487–491.
  13. Van Ramshorst G, Nieuwenhuizen J, Hop WCJ, et al. Abdominal wound dehiscence in adults: development and validation of a risk model. World J Surg 2010;34:20–27. DOI: 10.1007/s00268-009-0277-y.
  14. Hagel S, Scheuerlein H. Perioperative antibiotic prophylaxis and antimicrobial therapy of intra-abdominal infections. Viszeralmedizin 2014;30:310–316. DOI: 10.1159/000368582.
  15. Conde-Green A, Chung TL, Holton LH, et al. Incisional negative-pressure wound therapy versus conventional dressings following abdominal wall reconstruction. Ann Plast Surg 2013;71:394–397. DOI: 10.1097/SAP.0b013e31824c9073.
  16. Ko YS, Jung SW. Vacuum-assisted close versus conventional treatment for postlaparotomy wound dehiscence. Ann Surg Treat Res 2014;87(5):260–264. DOI: 10.4174/astr.2014.87.5.260.
  17. Arno D, Berrevoet F. Consequences of abdominal burst after midline laparotomy. Desertation. Netherlands: Faculty of Medicine and Health Sciences Ghent University; 2017.
  18. Wolff WI. Disruption of abdominal wounds. Ann of Surg 1950;131:534–555. DOI: 10.1097/00000658-195004000-00007.
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