Abstract
Objective: The purpose of the present study was to determine the perioperative factors associated with delayed wound closure in the repair of ruptured abdominal aortic aneurysm (RAAA).
Methods: A total of 64 patients underwent RAAA repair in our hospital between January 2006 and December 2009. We excluded 9 patients who had already experienced cardiopulmonary arrest before admittance our hospital and who died within 24 hours post operatively. The remaining 55 patients were divided into group A (38 patients with immediate wound closure) and group B (17 patients, delayed wound closure). We analyzed many factors in the 2 groups. Preoperative factors were age, systolic blood pressure, Rutherford classification, base excess (BE), hemoglobin (Hb) and creatine kinase (CK) levels; intraoperative factors were aortic clamp time, operative time, amount of blood loss, and red blood cell transfusion volume. We also compared operative mortality between the 2 groups.
Results: The mean age was (77.7±8.2 years in group A and 73.2±7.2 years in group B (p=0.048). Mean systolic blood pressure (114.5±28.6 mmHg, 80.4±21.2 mmHg) (p=0.0001), and BE (-4.96±5.67, -11.7±6.22) (p=0.0007) were higher in group A than in group B. The median Rutherford classification (2, 4), amount of blood loss (4105±1831 ml, 7417±4888 ml) (p=0.014), and transfusion volume (1467±592 ml, 2232±1056 ml) (p=0.01) were all lower in group A than in group B. The ratio of men to women (A=25:13, B=13:4) (p=0.431), CK level (A=914.6±4683 IU/l, B=98.1±76.9 IU/l) (p=0.29), Hb level (A=7.29±2.31 g/dl, B=6.85±1.63 g/dl) (p=0.419), aortic clamp time (A=28.7±17 min, B=29.6±25 min) (p=0.9), and operative time (A=284±87 min, B=335±102 min) (p=0.088) were all similar in both groups. The operative mortalies of the total of 64 patients, and of groups A and B were 27.7%, 5.3%, and 41%, respectively.
Conclusion: Mean age, systolic blood pressure, BE, amount of blood loss, and the amount of transfusion volume were all significant perioperative factors associated with delayed wound closure in the repair of RAAA in this study.
