A Study to Assess the Incidence of Post–Operative Complications among the Patients Undergone Abdominal Surgery in Dr. D. Y. Patil Medical Hospital Pimpri

Mr. Jitendra Patidar

Lecturer, Joitiba College of Nursing, Bhandu, Tal- Visnagar, Dist- Mehsana (Gujarat)

*Corresponding Author’s Email: pjitendra180@gmail.com

ABSTRACT:

Background- The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen. Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (stomach, kidney, liver, etc.) Diseases affecting the abdominal cavity are dealt with generally under their own names (e.g. appendicitis). Surgery is a stressful, complex event. Today as a result of advances in surgical techniques and instrumentation as well as in anesthesia, many surgical procedures that were once performed in an inpatient setting now takes place in an ambulatory or outpatient setting. Approximately 60% of elective surgeries are now performed in an ambulatory or outpatient setting. A study was conducted in Rajarajeshwari medical college hospital Bangalore This study aimed to determine the incidence of surgical site infection (SSI) in the abdominal surgeries and to identify risk factors associated with the development of SSI .All surgeries (1000 cases) where abdominal wall was opened were considered for the study. It was seen that overall surgical wound infection rate was 13.7%. The infection rate was more with emergency surgery (25.2%) when compared to elective surgery (7.6%). The surgical site infection rate increased as the risk index score increased from 0 to 3. SSI was more with early operative and post operative prophylaxis¹Aims and Objectives- To assess the incidence of post –operative complications among the patients undergone abdominal surgery. To correlate complications with demographic variable. Material and Methods: Data was collected from 100 patients with questionnaire and observation checklist to evaluate the post operative complications. Assessment done from 0day, 3day, 7day and follow up to observe post operative complications. Result: None of them had any post-operative DVT complication till day 7. On follow up, 14% of them had unilateral pitting edema. On day 0, 4% of them had adventitious breath sounds then it came down to 1% on day7 and remained same for follow up. On day 0, 8% of them had Sputum production, 2% of them, had Sputum production in follow up visit. 1% of them had abnormal respiratory rate on day3. 1% of them needed breathing efforts on day 0 and follow up visit. 1% of them had abnormal o2 saturation on day 0. 26% of them had swelling at the site of incision on day0, 14% of them had it on day3, and 4% on day7. 1% of them had necrotic tissue at wound on day 3 and day 7. 3% of them had Exudates / Discharge from wound on day 3 and 5% of them had it on day7. 6% of them had abnormal skin color surrounding the wound on day 0, 1% on day of follow up.2% of them had Gaping in wound on day 3. 39% of them had Elevated body Temperature on day 0, 2% of them had Elevated body Temperature on day 7. 4% of them had Pain at the incision site on follow up day. Conclusion: It can concluded that, none of them were any post-operative DVT complications till 7^th day, in follow up visit, 17% of them had mild signs of DVT complications. Mild signs of respiratory complications, mild signs of wound complications selected, none of the patient were signs of complications of incisional hernia till day 7. In follow up visit, 4% of them were mild signs of complications of incisional hernia. Selected post operative complications among the patients following abdominal surgery.

KEYWORDS:

INTRODUCTION:

Lewis stated that surgery can be defined as the art and science of treating diseases, injuries and deformities by operation and instrumentation .The surgical procedure involves the interaction of the patient, the surgeon and the nurse ². Postoperative complications may either be general or specific to the type of surgery undertaken and should be managed with the patient's history in mind. Common general postoperative complications include postoperative fever, atelectasis, wound infection, embolism and deep vein thrombosis and incisional hernia. Surgical site infections and wound and tissue dehiscence are well-known postoperative complications in gastrointestinal surgery. The severity of these complications embraces mild cases needing local wound care and antibiotics to serious cases with multiple re-operations and a high mortality rate. In most cases, such complications prolong hospitalization, with a substantial increase in cost of care. According to The National Institute for Health and Clinical Excellence, at least five percent of patients undergoing surgical operations develop surgical wound infections. In addition, at least 20 percent of all healthcare-associated infections come from surgical wounds. These infections can cause several complications. A study was therefore planned to assess the incidence of post –operative complications among the patients undergone abdominal surgery.

MATERIAL AND METHODS:

Descriptive study to assess the incidence of post –operative complications among the patients undergone abdominal surgery in Dr. D. Y. Patil Medical hospital Pimpri. Data was collected from questionnaire and observation checklist to evaluate the post operative complications. Assessment done from 0day, 3day, 7day and follow up to observe post operative complications. The significance will be calculated by using mean, standard deviation and calculated ‘t’ value. Anova will be used to find the co-relation with every item & the findings will be documented in tables, graphs & diagrams. Description and inferential statistics were used for analysis.

RESULT:

Finding revealed that none of them had any post-operative DVT complication till day 7. On follow up, 14% of them had unilateral pitting edema, 12% of them had Pitting edema and 1% of them had swelling of entire leg. On day 0, 4% of them had adventitious breath sounds which increased to 15% on day3 then it came down to 1% on day7 and remained same for follow up.

On day 0, 8% of them had Sputum production which increased to 16% on day 3, which was 10% on day 7 and 2% of them, had Sputum production in follow up visit. 1% of them had abnormal respiratory rate on day3. 1% of them needed breathing efforts on day 0 and follow up visit. 1% of them had abnormal o2 saturation on day 0. 26% of them had swelling at the site of incision on day0, 14% of them had it on day3, and 4% on day7. 1% of them had necrotic tissue at wound on day 3 and day 7. 3% of them had Exudates / Discharge from wound on day 3 and 5% of them had it on day7. 6% of them had abnormal skin color surrounding the wound on day 0, which increased to 15% on day 3, which again reduced to 5% on day 7 and 1% on day of follow up.2% of them had Gaping in wound on day 3. 39% of them had Elevated body Temperature on day 0, which reduced to 26% on day3 and 2% of them had Elevated body Temperature on day 7. 4% of them had Pain at the incision site on follow up day. Findings revealed that since p-value corresponding to education is small (less than 0.05) Education was found to have significant association with the post-operative pain among the patients undergone abdominal surgery. Findings revealed that since p-value corresponding to gender and age are small (less than 0.05). Demographic variables gender and age were found to have significant association with the post-operative respiratory complications among the patients undergone abdominal surgery. Findings revealed that since p-value corresponding to age is small (less than 0.05). Age was found to have significant association with the post-operative wound complications among the patients undergone abdominal surgery.

DISCUSSION

It should be emphasized that, none of them were any post-operative DVT complications till 7^th day, in follow up visit, 17% of them had mild signs of DVT complications. Mild signs of respiratory complications, mild signs of wound complications selected, none of the patient were signs of complications of incisional hernia till day 7. In follow up visit, 4% of them were mild signs of complications of incisional hernia. Selected post operative complications among the patients following abdominal surgery.

CONCLUSION

The aim of the study was to assess the incidence of post –operative complications among the patients undergone abdominal surgery. This data will assist the health workers to detect post operative complications in patients. Through this study nurses or other health worker can take proper action before the patient condition detoriates more. Early treatment can be given by detecting early signs of complications.

REFRENCE:

1. Satyanarayana V., Dr. Prashanth H.V. Journal of Clinical and Diagnostic Research. 2011 October, Vol-5(5),Pp- 935-939

2. Lewis, Heitkemper, Dirksen, Medical Surgical nursing,6^th edition, St.Louis, Mosby publishers, 2004, 929-33

3. Joyce m black Medical-surgical nursing: Clinical management for clinical management for positive outcomes, Elsevier Publication 8th edition, Pp 219-225.

Received on 22.07.2016 Modified on 29.08.2016

Int. J. Nur. Edu. and Research. 2016; 4(4): 485-486.

DOI: 10.5958/2454-2660.2016.00088.0