학술논문

Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study
Document Type
article
Source
Ethiopian Journal of Health Sciences. 31(1)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Pediatric
Patient Safety
Prevention
Zero Hunger
Good Health and Well Being
Child
Child
Preschool
Ethiopia
Humans
Laparotomy
Male
Prospective Studies
Risk Factors
Surgical Wound Infection
Pediatrics
SSI
Wound dehiscence
Global Surgery
Clinical sciences
Public health
Language
Abstract
BackgroundSurgical 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.MethodsWe 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.ResultsOf 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 (p1 hour before surgery and operative time >2 hours are independent predictors of SSI.