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Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer
Capio St Goran Hosp, Dept Surg, Stockholm, Sweden;Karolinska Inst, Sodersjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden.
Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden.
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Experimental Surgery.
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2019 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 34, no 10, p. 1757-1762Article in journal (Refereed) Published
Abstract [en]

Background

Patient-related risk factors for wound dehiscence after colorectal surgery remain obscure.

Methods

All open abdominal procedures for colorectal cancer registered in the Swedish Colorectal Cancer Registry (SCRCR, 5) 2007–2013 were identified. Potential risk factors for wound dehiscence were identified by cross-matching between the SCRCR and the National Patient Register (NPR). The endpoint in this study was reoperation for wound dehiscence registered in either the SCRCR or NPR and patients not reoperated were considered controls.

Results

A total of 30,050 patients were included in the study. In a multivariable regression analysis, age > 70 years, male gender, BMI > 30, history of chronic obstructive pulmonary disease, history of generalised inflammatory disease, and duration of surgery less than 180 min were independently and significantly associated with increased risk for wound dehiscence. A history of diabetes, chronic renal disease, liver cirrhosis, and distant metastases was not associated with wound dehiscence. The hazard ratio for postoperative death was 1.24 for patients who underwent reoperation for wound dehiscence compared with that for controls.

Discussion

Patients reoperated for wound dehiscence face a significantly higher postoperative mortality than those without. Risk factors include male gender, age > 70 years, obesity, history of chronic obstructive pulmonary disease, and history of generalised inflammatory disease. Patients at high risk for developing wound dehiscence may, if identified preoperatively, benefit from active prevention measures implemented in routine surgical practice.

Place, publisher, year, edition, pages
2019. Vol. 34, no 10, p. 1757-1762
Keywords [en]
Wound dehiscence, Colorectal cancer, Surgery
National Category
Gastroenterology and Hepatology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-395788DOI: 10.1007/s00384-019-03390-3ISI: 000487143200015PubMedID: 31501927OAI: oai:DiVA.org:uu-395788DiVA, id: diva2:1366181
Funder
The Karolinska Institutet's Research FoundationAvailable from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-10-28Bibliographically approved

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