Thoracotomy Wound Dehiscence in Pulmonary Tuberculosis Patients

The objective: to detect causes of thoracotomy wound dehiscence in the patients who underwent surgery for pulmonary tuberculosis. Subjects and Methods. 960 HIV-negative patients who underwent surgery for pulmonary tuberculosis from 2018 to 2023 were included in the study. Thoracotomy was performed in 851 patients, of whom 285 (33.5±1.6%) had MDR/XDR TB, and thoracoplasty was performed in 109 patients, of whom 58 (53.2±4.8%) had MDR/XDR TB. Results. Out of operated 960 patients, a complication such as thoracotomy wound dehiscence (TWD) was reported in 69 (7.2±0.8%) cases, among whom men prevailed. The study did not establish a statistically significant relationship between the incidence of TWD and the type of intervention, dissemination of the disease, or the presence of concomitant conditions. The incidence of TWD was the highest (39/61 (63.9±6.2%)) during thoracotomy with insufficient aerostasis; during thoracoplasty, there was no such complication at all. In the absence of other postoperative complications, TWD occurred statistically significantly more often during thoracoplasty than thoracotomy (4/8 (50±17.7%) versus 9/61 (14.8±4.5%), p =0.017). In patients with TWD, a predominance of MDR/XDR TB was established in both types of surgical interventions (in 35/61 (57.4±6.3%) during thoracotomy, 5/8 (62.5±17.1%) during thoracoplasty, p >0.05). Moreover, the OR of developing TWD was higher in patients with MDR/XDR TB (2.68; 95% CI 1.6-4.4; p χ2 <0.001).