INTRODUCTION Surgical abdominal wound dehiscence (WD) is a serious complication. At best, the patient is subjected to the inconvenience of a dis- charging wound and the later appearance of an incisional hernia; at worst, immediate re- operation is required, with a fatal outcome in approximately 20% of cases (7). Despite increased knowledge concerning wound healing and progress in perioperative and postoperative care over the past few decades, WD after abdominal injury continues to be a problem which considerably prolongs hos- pital stay and is associated with mortality rates of 10-44% (5, 10, 13, 14, 20). Factors related to WD are surgeon-experi- ence, type of incision, suture material, drain, ostomy, and to patient-related factors such as age, nutritional state, and a co-existing dis- ease (5). To identify factors contributing to the development of WD, we reviewed 11,329 major abdominal operations at the biggest teaching hospital in Turkey, and compared WD patients with randomly selected controls standardized by age and sex and operated on during the same period. The aim of this study was to evaluate the risk factors of WD and determine which factors could be pre- dictable. PATIENTS and METHODS Between 1992 and 1996, 11,329 major abdominal laparotomies were performed in the Department of General Surgery, Ankara Numune Teaching Hospital. Forty patients were reported with complete wound dehis- cence (group 1). During the same time peri- od, 40 non-wound dehiscence (Non-WD) patients (group 2) were selected to serve as controls. The medical records of all patients were reviewed and local and systemic fac- tors, surgeons’ experience, operative proce- dure, suture materials, drain, and postopera- tive morbidity were considered and com- pared separately. Clinically jaundiced patients had a serum total bilirubin level ＞50 umol/L (normal 2 to 20). Anemia was defined as a hemoglobin value of less than 10 g/100d Î (normal 10-14 g/d Î ), and leucocytosis as a white blood cell count greater than 10,000 cells/ μ Î. Hypertension was defined as blood pressure exceeding 160/100 mmHg or a history of Tokai J Exp Clin Med., Vol. 23, No. 3, pp.123-127, 1998 Atilla SORAN, 446 S. Aiken Ave. Apt 4, Pittsburgh, PA 15232 USA, Fax: 412 647 8060, e. mail: asoran+@pitt. edu Can Postoperative Abdominal Wound Dehiscence be Predicted? Cavit ÇÖL, Atilla SORAN and Meltem ÇÖL Department of General Surgery, Ankara Numune Teaching Hospital, Turkey (Received April 1, 1998; Accepted April 4, 1998) The purpose of this study was to identify risk factors in wound dehiscence and to determine which factors might be predictable. Forty patients with abdominal wound dehiscence were compared with 40 control patients standardized by sex and age. Hypoproteinemia, nausea/vomiting, fever, wound infection, abdominal distension, type of suture material, 2 or more abdominal drains, and the surgeon’s experience were factors significantly associated with wound dehiscence. Emergency surgery, jaundice, ostomy, total parenteral nutrition, ascites, pulmonary morbidity, co-existence of disease, anemia, leucocytosis, and type of inci- sion were nonsignificant variables. The number of patients with wound dehiscence increased with an increase in the number of risk factors, reaching 100% for patients with 8 risk factors. The risk factors of wound dehiscence can be predicted early and their number can be decreased before and after surgery by an experienced surgeon, leading to a lowered incidence of wound failure. (Key Words: Abdomen, wound dehiscence, risk factors) 123