EGS SO03 - Audit of wound complications after Emergency laparotomies in A University Teaching Hospital: 2-cycle Prospective Audit

Background

Wound infections and incisional hernias are frequent complications that can occur after an emergency laparotomy. The surgical technique used plays a crucial role in determining the likelihood of complications. The objective of this audit was to evaluate our technique in performing emergency midline incision closure and to compare our complication rates with those of established guidelines.

Method

A two-year prospective audit, comprising two cycles, was conducted at a teaching university hospital to evaluate the incidence of wound infections following emergency laparotomy. During each cycle, which lasted for one year, 1423 patients underwent an emergency laparotomy.

Results

The initial outcomes showed that wound infection rate was 123 out of 621, which translates to 19.8%, the overall rate of acute fascial rupture was 66 out of 621, amounting to 10.6%, while overall incisional hernia rate was 87 out of 621, which equals 14%.

In the subsequent cycle, wound infection rate was 49 out of 802, corresponding to a percentage of 6.2%. The overall rate of acute fascial rupture was 34 out of 802, which is equivalent to a percentage of 4.3%, while the overall incisional hernia rate was 42 out of 802, which translates to 5.2%.

Conclusion

In conclusion, the audit revealed several areas of improvement to address in order to enhance its overall performance and achieve its goals of decreasing our rate of wound complications after urgent laparotomy which needs our adherence to this closure technique