Risk Factor Assessment for Wound Dehiscence Following CaesareanSection: A Study from a Tertiary Care Center in Bihar

Background: Wound dehiscence is a significant postoperative complication following caesarean sections, leadingto increased morbidity, prolonged hospital stays, and higher healthcare costs. Various maternal, surgical, andpostnatal factors contribute to wound dehiscence, making early identification of high-risk cases crucial forimproving surgical outcomes. Factors such as obesity, diabetes, hypertension, anemia, prolonged labor,chorioamnionitis, surgical technique, and improper postoperative wound care have been implicated in woundhealing complications. This study aims to evaluate the risk factors associated with wound dehiscence followingcaesarean sections at a tertiary care hospital in Bihar.Objectives: This study aims to assess the prevalence and risk factors of wound dehiscence in post-caesareanpatients, evaluate the impact of maternal comorbidities and surgical factors, and analyze the relationship betweenintraoperative and postoperative complications and wound healing.Methods: A prospective observational study was conducted at the Department of Obstetrics and Gynaecology,Patna Medical College and Hospital, Patna, Bihar, India, over twelve months. A total of 120 post-caesareanpatients who developed wound dehiscence were included in the study and compared with 120 matched controlswho had uneventful wound healing. Data on patient demographics, maternal comorbidities (diabetes,hypertension, anemia), BMI, nutritional status, duration of labor, presence of chorioamnionitis, intraoperativefactors (type of incision, duration of surgery, blood loss), and postoperative care were collected and analyzed. Thewound was assessed using standard criteria, including signs of infection, gaping, and serous or purulent discharge.Statistical analysis was performed to determine significant risk factors.Results: The incidence of wound dehiscence was 8.5% among post-caesarean patients. Obesity (BMI > 30 kg/m²)was observed in 32% of cases, while diabetes mellitus (24%) and anemia (36%) were also significantly associatedwith wound dehiscence. Prolonged labor (>12 hours) and emergency caesarean sections (60%) were identified asindependent risk factors (p < 0.01). Chorioamnionitis was present in 18% of cases, contributing to infection-related wound breakdown. The use of vertical midline incisions (22%) and increased intraoperative blood losswere significantly associated with dehiscence. Patients with inadequate postoperative wound care and earlymobilization had a higher risk of wound complications.Conclusion: Wound dehiscence following caesarean section is influenced by multiple risk factors, includingobesity, diabetes, anemia, prolonged labor, emergency surgeries, and surgical technique. Optimizing maternalhealth, improving intraoperative hemostasis, and ensuring adequate postoperative wound care can significantlyreduce the incidence of wound complications. Preventive strategies, including better glycemic control, nutritionalsupport, and the use of standardized surgical techniques, are essential in improving maternal surgical outcomes incaesarean deliveries