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Abdominal wound dehiscence is dangerous: a nationwide study of 14,169 patients undergoing elective open resection for colonic cancer

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Abstract

Purpose

The potential impact of abdominal wound dehiscence on long-term survival after elective abdominal surgery is largely unknown. The aim of this study was to examine the impact of abdominal wound dehiscence on survival and incisional hernia repair after elective, open colonic cancer resection.

Methods

This was a nationwide cohort study based on merged data from Danish national registries, comprising patients subjected to elective, open resection for colonic cancer between May 1, 2001 and January 1, 2016. Multivariable Cox Regression analysis and propensity score matching was applied to adjust for confounding. The associations of abdominal wound dehiscence with 90-day mortality and subsequent incisional hernia repair were also examined.

Results

A total of 14,169 patients were included in the cohort, of which 549 (3.9%) developed abdominal wound dehiscence. The 5-year survival was significantly decreased in patients with abdominal wound dehiscence (42.4%, 95% CI 38.1–46.7 vs. 53.4%, 52.6–54.3, P < 0.001), which was confirmed in the multivariable analysis (HR 1.22, CI 1.06–1.39, P = 0.004). Abdominal wound dehiscence was significantly associated with increased risk of 90-day mortality (OR 1.60, CI 1.12–2.27, P = 0.009) as well as subsequent incisional hernia repair (HR 1.80, CI 1.07–3.01, P = 0.026).

Conclusions

Abdominal wound dehiscence was significantly associated with decreased survival. Fascial closure after open colonic cancer resection should be given high priority to improve the long-term survival.

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Acknowledgements

The authors thank Dr. Henrik Harling for the conception of the study hypothesis, and Dr. Steffen Høgskilde for help with data retrieval.

Author information

Authors and Affiliations

  1. Digestive Disease Center, Bispebjerg University Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    K. K. Jensen, E. Oma, A. Nordholm-Carstensen & P.-M. Krarup

  2. Department of Gastrointestinal Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Gent, Belgium

    G. H. van Ramshorst

Authors
  1. K. K. Jensen
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  2. E. Oma
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  3. G. H. van Ramshorst
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  4. A. Nordholm-Carstensen
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  5. P.-M. Krarup
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Corresponding author

Correspondence to K. K. Jensen.

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Conflict of interest

KKJ, EO, GvR, ANC and PMK all declare they have no conflicts of interest.

Ethical approval

According to Danish law on register research, an ethical approval was not neccessary.

Human and animal rights

This article does not contain any study with animals performed by any of the authors.

Informed consent

As all patients were anonymous in the current register study, no informed consent was required.

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Appendix

Appendix

See Tables

Table 4 Patient demographics after 1:3 propensity score matching according to abdominal wound dehiscence after elective, open colonic cancer resection
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Table 5 Logistic regression of factors associated with 90-day mortality after elective open colonic cancer resection
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Table 6 Multivariable Cox proportional hazards regression analysis of factors associated with incisional hernia repair subsequent to elective open colonic cancer resection.`
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6.

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Jensen, K.K., Oma, E., van Ramshorst, G.H. et al. Abdominal wound dehiscence is dangerous: a nationwide study of 14,169 patients undergoing elective open resection for colonic cancer. Hernia 26, 75–86 (2022). https://doi.org/10.1007/s10029-020-02350-z

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