Wound Dehiscence Following Obstetrics and Gynecology Surgeries: An Observational Study at a Tertiary Hospital in Bandung

Abstract

Introduction: Wound dehiscence is a severe postoperative complication that disrupts an abdominal wound closure which can be caused by endogenous or exogenous flora that infect a surgical wound. Many factors are responsible for surgical site infection in obstetric and gynecology patients considering all the basic standards are ideally maintained in tertiary care hospitals. To identify the characteristics of surgical wound dehiscence (SWD) patients who underwent obstetric and gynecological surgeries at Dr. Hasan Sadikin Hospital from 2021 to 2022.
Methods: This study utilized a quantitative descriptive approach with a retrospective design.
Results: A total of 43 subjects were included in the study and were divided into three groups based on their surgery type: obstetrics (n=11), gynecology (n=7), and gynecological oncology (n=25). The majority of SWD cases were associated with gynecological oncology surgeries. The patients were predominantly aged 18-65 years (88%), had superficial SWD (65%), normal BMI (37%), were non-smokers (67%), had a history of steroid medication usage (63%), received prophylactic antibiotics (63%), underwent elective surgery (58%), had laparotomy surgeries (100%), with a duration of ≥180 minutes (35%), and intraoperative bleeding of ≤1500 cc (63%). The surgical wounds were primarily classified as clean type (47%), and therapeutic antibiotics were administered to the majority of patients (74%).
Conclusion: Most of our findings were consistent with existing theories. However, the discrepancies observed in some outcomes can serve as an evaluative tool to assess the adherence of current practices to established guidelines. It is crucial to consider the risk factors for SWD when developing preventive strategies.

Dehisensi Luka Pascaoperasi Obstetri dan Ginekologi: Sebuah Studi Observasi di Rumah Sakit Tersier Di Bandung

Abstrak
Pendahuluan: Dehisensi luka pascaoperasi merupakan komplikasi serius yang dapat mengganggu penutupan luka di perut yang disebabkan oleh adanya flora bersumber secara endogen atau eksogen yang menginfeksi luka operasi. Banyak faktor yang berperan dalam infeksi daerah operasi walaupun sudah dilakukannya semua standar operasional yang selalu dipertahankan di rumah sakit perawatan tersier. Untuk mengetahui karakteristik pasien dehisensi luka pascaoperasi obstetri dan ginekologi di RSUP Dr. Hasan Sadikin.
Metode: Penelitian ini merupakan penelitian deskriptif retrospektif yang menganalisis faktor praoperatif, intraoperatif, dan pascaoperatif dari subjek penelitian.
Hasil: Pada studi ini, terdapat 43 subjek yang selanjutnya dikategorikan menjadi tiga kelompok berdasarkan jenis operasinya: obstetri (n=11), ginekologi (n=7), dan onkologi ginekologi (n=25). Sebagian besar kasus berhubungan dengan operasi onkologi ginekologi, berusia 18 - 65 tahun (88%), memiliki dehisensi luka superfisial (65%), indeks massa tubuh normal (37%), bukan perokok. (67%), memiliki riwayat penggunaan obat steroid (63%), menerima antibiotik profilaksis (63%), menjalani operasi elektif (58%), menjalani operasi melalui laparotomi (100%), dengan durasi ≥180 menit (35%), memiliki luka operasi tipe bersih (47%), mengalami perdarahan intraoperative ≤1500 cc (63%), dan mendapatkan antibiotik terapeutik (74%).
Kesimpulan: Sebagian besar hasil studi didapatkan sesuai dengan teori yang telah ada. Kesenjangan yang ditemukan pada luaran studi dapat menjadi alat evaluasi untuk menilai ketaatan pada praktik yang dilakukan untuk kemudian dijadikan pedoman praktik. Penting juga untuk mempertimbangkan faktor risiko dari dehisensi luka pascaoperasi ketika akan mengembangkan strategi preventif.

Kata kunci: dehisensi luka pasca operasi, faktor risiko, praoperasi, intraoperasi, pascaoperasi