Risk Factors For Wound Dehiscence After Posterior Sagittal Anorectoplasty In Children With Anorectal Anomalies

ABSTRACT:
Background/purpose: Wound dehiscence after PSARP is a considerable complication which may affect the functional outcome. The aim of our study is to assess the frequency of wound dehiscence after posterior sagittal anorectoplasty done for children with ARM and to identify the possible risk factors predisposing for it.
Methods: A retrospective chart study where files of children with ARM who underwent PSARP in Pediatric Surgery Department in Zagazig University between 2015 and 2020 were reviewed and analysed regarding the incidence of post-operative wound dehiscence and the possible predisposing factors including type of surgery, was it single- or multi-staged, gender, age, prematurity, birth weight, type of ARM, associated anomalies and use of antibiotics.
Results: Eighty-six patients with ARM operated by PSARP were included. Multi-staged repair was done in 49 patients and single-staged in 37 patients. Wound dehiscence was significantly more common in single-staged repair (43.2%), while only 20.5% of patients of multi-staged group experienced dehiscence. ARM associated with cardiac anomalies is another significant risk factor. None of the other studied factors was identified to be considered as a risk factor for dehiscence.
Conclusion: Wound dehiscence was more common in single-staged PSARP. Association of cardiac anomalies is another significant risk factor for wound dehiscence. We recommend to avoid single-staged PSARP in patients of ARM associated with cardiac anomalies, to avoid adding of another risk factor. No other significant risk factor for wound dehiscence was detected in our study. Further studies are recommended to search for other possible contributing factors.