The Role of Plateau Pressure in Predicting Wound Dehiscence in Patients Undergoing Exploratory Laparotomy

Abstract

Background: Wound dehiscence is a serious surgical complication associated with exploratory laparotomy, often leading to significant morbidity and mortality. Identifying predictive parameters for wound dehiscence is essential for improving patient outcomes. This retrospective study aimed to evaluate the utility of plateau pressure, a parameter typically used in mechanical ventilation, as a predictive tool for wound dehiscence in patients undergoing exploratory laparotomy. Methods: Data were collected from 100 patients admitted to tertiary care Centre, Karad, between December 2020 and May 2022. Demographic characteristics, etiological aspects, preoperative albumin levels, and diabetes mellitus status were recorded. Plateau pressure values were obtained from mechanical ventilation records. The primary outcome was the occurrence of wound dehiscence. Statistical analysis included descriptive statistics, chi-squared tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression. Results: Among the 100 patients, 12 (12%) developed wound dehiscence. Patients with plateau pressures greater than 25 cmH2O exhibited the highest incidence of wound dehiscence (53.6%). A significant association was found between higher plateau pressure values and an increased risk of wound dehiscence (p < 0.05). Multivariate logistic regression confirmed this association, adjusting for potential confounding factors. Conclusion: This study suggests that elevated plateau pressure may serve as a valuable predictive parameter for wound dehiscence in exploratory laparotomy patients. The findings highlight the potential clinical significance of incorporating plateau pressure into preoperative risk assessment and preventive strategies, ultimately contributing to improved patient care and outcomes. Further research is warranted to validate and expand upon these findings.