Determinant of Abdominal Wound Dehiscence (AWD) in Post-Laparotomy Patients

Introduction. Abdominal wound dehiscence (AWD) is a significant risk factor for mortality during the perioperative period. The high mortality rate, prolonged hospitalization, and increased incidence of repeat operations increase in hospital costs result in worsening the AWD problem itself. This study aims to determine the determinants of abdominal wound dehiscence in post-laparotomy patients at the Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Methods. This study is quantitative analytical research with a cross-sectional design to determine the determinants of abdominal wound dehiscence (AWD) in post-laparotomy patients based on secondary data from medical records at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. A total of 161 research subjects participated in this study. Results. Emergency surgery patients are 0.4 times more likely to experience AWD than elective patients. Then, patients who experience hypoalbuminemia have 1.8 times the risk, those aged more than 60 years have 0.5 times the risk, sepsis has 1.5 times the risk, and trauma patients have 0.8 times the risk of experiencing AWD. Conclusion. Emergency surgery is the most influential determinant in the incidence of AWD at Dr. Mohammad Hoesin Palembang, Indonesia.

Introduction.Abdominal wound dehiscence (AWD) is a significant risk factor for mortality during the perioperative period.The high mortality rate, prolonged hospitalization, and increased incidence of repeat operations increase in hospital costs result in worsening th e AWD problem itself.This study aims to determine the determinants of abdominal wound dehiscence in post-laparotomy patients at the Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.Methods.This study is quantitative analytical research with a cross-sectional design to determine the determinants of abdominal wound dehiscence (AWD) in post-laparotomy patients based on secondary data from medical records at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.A total of 161 research subjects participated in this study.Results.Emergency surgery patients are 0.4 times more likely to experience AWD than elective patients.Then, patients who experience hypoalbuminemia have 1.8 times the risk, those aged more than 60 years have 0.5 times the risk, sepsis has 1.5 times the risk, an d trauma patients have 0.8 times the risk of experiencing AWD.Conclusion.Emergency surgery is the most influential determinant in the incidence of AWD at Dr. Mohammad Hoesin Palembang, Indonesia.

Sriwijaya Journal of Surgery
causes of AWD (all p values< 0.05). 6,77][8][9] This study aims to determine the determinants of abdominal wound dehiscence in post-laparotomy patients at the Dr.

Methods
This study is quantitative analytical research with Secondary data is collected from medical records and then coded according to research needs, and data entry is carried out.The data was then analyzed using SPSS (Statistical Package for Social Science) software version 25.The data was then analyzed bivariate using chi-square.Then, the data was analyzed multivariate to determine the magnitude of the effect using logistic regression analysis.
This shows a relationship between hypoalbuminemia, sepsis, and emergency surgery with the incidence of AWD. times the risk of experiencing AWD.

Discussion
Bleeding volume is not an accurate predictor of mortality in epidural hemorrhage patients undergoing surgery at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
In this study, there was a relationship between hypoalbuminemia and the incidence of AWD (p=0.028).This is in line with other studies showing the presence of hypoalbuminemia and AWD incidence at Dr. Mohammad Hoesin General Hospital, Palembang, also uses the same standard in determining hypoalbuminemia, namely below 3.5 g/dl.Other studies show that albumin below 3.5 g/dl indicates protein energy malnutrition in patients, so wound healing will be hampered due to the effect on fibroblast proliferation, collagen synthesis, and angiogenesis.This study also showed a relationship between sepsis and AWD (p=0.017).This is also in line with other research, which states a relationship between sepsis and the incidence of wound dehiscence.

Conclusion
Emergency surgery is the most influential determinant in the incidence of AWD at Dr.
wound dehiscence (AWD) in post-laparotomy patients based on secondary data from medical records at Dr. Mohammad Hoesin General Hospital Palembang.A total of 161 research subjects participated in this study, where the research subjects met the inclusion criteria.The inclusion criteria for this study were patients who underwent laparotomy surgery in the digestive surgery department, patients aged 18 years and over, and had complete medical record data.This study has received ethical approval from the medical and health research ethics committee of Dr. Mohammad Hoesin General Hospital Palembang.All determinants found in patients are age, , kidney failure, sepsis, diabetes mellitus (DM), as well as determinants related to surgery such as elective or emergency surgery, trauma or non-trauma patients, and type of incision.

Table 2 .
Multivariate analysis of determinants with AWD.
Based on the data above, it was found that the determinant of the type of surgery was the strongest variable that influenced the incidence of AWD, followed by hypoalbuminemia, age, sepsis, and the patient category.Emergency surgery patients are 0.4 times more likely to experience AWD than elective