Wound Dehiscence Following Midline Laparotomy: Risk Factors and Prevention at Federal Medical Centre, Owerri

Wound dehiscence following midline laparotomy is a serious postoperative complication with high morbidity and economic burden on both patients and healthcare institutions. This study identifies the risk factors and preventive strategies associated with wound dehiscence at Federal Medical Centre (FMC), Owerri, Imo State, South East Nigeria. A case-control study design was employed, comparing 60 patients who developed wound dehiscence to 120 matched controls who did not, from surgical records spanning 2020 to 2024. Variables analyzed included body mass index, nutritional status, indication for surgery, type of suture material, wound classification, presence of intraabdominal sepsis, and postoperative cough. Binary logistic regression was used to determine independent predictors. Malnutrition, emergency surgery, intraabdominal sepsis, and inappropriate suture material emerged as statistically significant risk factors. Interestingly, early postoperative physiotherapy and adequate nutritional supplementation were associated with significantly lower dehiscence rates. The study recommends preoperative nutritional optimization, standardized fascial closure techniques using mass closure with loop nylon sutures, and postoperative physiotherapy protocols. Surgeons at FMC Owerri and similar institutions in South East Nigeria should adopt evidence-based wound closure guidelines to minimize this preventable complication. Keywords: wound dehiscence, laparotomy, risk factors, malnutrition, FMC Owerri