Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy

Article Article scientifique Article Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy eng 2023-10-10 2024-08 author Miholjcic Tina Bénédicte Sara Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 879354 author Baud Olivier 0000-0001-5021-0522 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neonatal and Pediatric Intensive Care, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 42968 author Iranmanesh Pouya Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland. 565405 Département de chirurgie (CHIRU) author Wildhaber Barbara Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 595596 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 351-362 10.1055/s-0043-1771223 37816380 0939-7248 PMC11226331 https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1771223 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. Humans Infant, Newborn Risk Factors Surgical Wound Dehiscence / etiology Surgical Wound Dehiscence / epidemiology Retrospective Studies Laparotomy / adverse effects Female Male Infant, Premature Incidence Dewey 617 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 57 Département de chirurgie 222 false 546 Recherche clinique en chirurgie pédiatrique 886 1251 Prévention des complications néonatales d'origine périnatale 990 European journal of pediatric surgery 34 4 ffa1e27c-dc9c-45cc-8d1e-df0c7ec99099 Article (Published version) Public Article_scientifique_from_unpaywall.pdf 1043632 application/pdf CC BY-NC-ND-4.0 df6b39e5a987c54a5e7b4ae1f1575d1ad772bab1fe2a70fc5cc39a8366b1fd4b Vignette Public 10-1055-s-0043-1771223-i2023056653oa-toc.jpg 135587 image/png openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de chirurgie

Title	Published in	Access level	OA Policy	Year	Views	Downloads

Risk Factors for Dehiscence of Operative Incisions in Newborns after Laparotomy	European journal of pediatric surgery			2024	18	344

Archive ouverte UNIGE

Baud, Olivier