71: THE APPLICATION OF SUBCUTANEOUS TALC IN PANNICULECTOMIES AND SUBCUTANEOUS ADVANCEMENT FLAPS WITH CONCOMITANT HERNIA REPAIR REDUCES DRAIN DURATION AND POST-OPERATIVE WOUND COMPLICATIONS

Objective: To evaluate the postoperative abdominal wound problem after hysterectomy with scalpel versus electrocautery for skin and subcutaneous dissection. Material and Methods: A total of 516 post-menopausal women having age 40 to 65 years who were planned for elective hysterectomy were included in this study. Patients having only benign disorders were included. In group E (N=258); Skin incision and tissue dissection was done using electrocautery by setting the electrocautery machine at cutting mode at 30 to 50 watts’ power. In group S (N=258); conventional scalpel was used for skin incision. Scalpel number 23 was used for skin and subcutaneous tissue dissection. Post-operative wound complications such as seroma, hematoma, wound dehiscence and wound infections were primary study endpoints. Results: Mean age was 48.6±6.9 years in electrocautery and 49.2±6.3 years in scalpel group (p-value 0.30). Seroma formation was diagnosed in 98 (37.98%) patients in electrocautery group and in 52 (20.1%) patients in scalpel group (p-value <0.0001). Wound infections were diagnosed in 50 (19.3%) patients in electrocautery group versus in 87 (33.7%) patients in scalpel group (p-value 0.0002). Hematoma was diagnosed in 10 (3.87%) patients in electrocautery group and in 19 (7.4%) in scalpel group (p-value 0.08). Conclusion: The use of electrocautery is associated with lower rate of post-operative wound infections and hematoma formation. The present study advocates the use of electrocautery for skin and subcutaneous tissue dissection in patients undergoing abdominal hysterectomy. Keywords: Abdominal hysterectomy, electrocautery, scalpel, wound complications.

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Wound Complications after Hernia Repair in Patients with Ascites: an Analysis of the ACS-NSQIP Database

Journal of Surgical Research ◽

10.1016/j.jss.2013.11.764 ◽

2014 ◽

Vol 186 (2) ◽

pp. 673

Author(s):

B.R. Englum ◽

P.J. Speicher ◽

A.M. Ganapathi ◽

J.E. Scarborough

Keyword(s):

Hernia Repair ◽

Wound Complications ◽

Acs Nsqip ◽

Acs Nsqip Database

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The impact of 3D conformal radiotherapy versus intensity-modulated radiotherapy on post-operative wound complications in soft tissue sarcomas of the extremity and chest-wall

Journal of Radiation Oncology ◽

10.1007/s13566-016-0277-0 ◽

2016 ◽

Vol 5 (4) ◽

pp. 389-394 ◽

Cited By ~ 2

Author(s):

Hina Saeed ◽

Candice Johnstone ◽

David M. King ◽

John Charlson ◽

Donald A. Hackbarth ◽

...

Keyword(s):

Soft Tissue ◽

Chest Wall ◽

Soft Tissue Sarcomas ◽

Intensity Modulated Radiotherapy ◽

Conformal Radiotherapy ◽

Wound Complications ◽

Intensity Modulated ◽

3D Conformal Radiotherapy ◽

The Impact ◽

Operative Wound

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Impact of Modifiable Comorbidities on Wound Complications after Ventral Hernia Repair

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2018.08.372 ◽

2018 ◽

Vol 227 (4) ◽

pp. e136

Author(s):

Hemasat Alkhatib ◽

Luciano Tastaldi ◽

Clayton C. Petro ◽

Dominykas Burneikis ◽

David Krpata ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Wound Complications

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National Outcomes for Open Ventral Hernia Repair Techniques in Complex Abdominal Wall Reconstruction

The American Surgeon ◽

10.1177/000313481508100815 ◽

2015 ◽

Vol 81 (8) ◽

pp. 778-785 ◽

Cited By ~ 13

Author(s):

Samuel W. Ross ◽

Bindhu Oommen ◽

Ciara Huntington ◽

Amanda L. Walters ◽

Amy E. Lincourt ◽

...

Keyword(s):

Length Of Stay ◽

Hernia Repair ◽

Ventral Hernia ◽

Multivariate Regression ◽

Ventral Hernia Repair ◽

Abdominal Wall Reconstruction ◽

Wound Complications ◽

Improvement Program ◽

Major Complications ◽

Open Ventral Hernia Repair

Modern adjuncts to complex, open ventral hernia repair often include component separation (CS) and/or panniculectomy (PAN). This study examines nationwide data to determine how these techniques impact postoperative complications. The National Surgical Quality Improvement Program database was queried from 2005 to 2013 for inpatient, elective open ventral hernia repairs (OVHR). Cases were grouped by the need for and type of concomitant advancement flaps: OVHR alone (OVHRA), OVHR with CS, OVHR with panniculectomy (PAN), or both CS and PAN (BOTH). Multivariate regression to control for confounding factors was conducted. There were 58,845 OVHR: 51,494 OVHRA, 5,357 CS, 1,617 PAN, and 377 BOTH. Wound complications (OVHRA 8.2%, CS 12.8%, PAN 14.4%, BOTH 17.5%), general complications (15.2%, 24.9%, 25.2%, 31.6%), and major complications (6.9%, 11.4%, 7.2%, 13.5%) were different between groups ( P < 0.0001). There was no difference in mortality. Multivariate regression showed CS had higher odds of wound [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.5–2.0], general (OR 1.5, 95% CI: 1.3–1.8), and major complications (OR 2.1, 95%, CI: 1.8–2.4), and longer length of stay by 2.3 days. PAN had higher odds of wound (OR 1.5, 95%, CI: 1.3–1.8) and general complications (OR 1.7, 95% CI: 1.5–2.0). Both CS and PAN had higher odds of wound (OR 2.2,95%, CI: 1.5–3.2), general (OR 2.5, 95%, CI: 1.8–3.4), and major complications (OR 2.2, 95%CI: 1.4–3.4), and two days longer length of stay. In conclusion, patients undergoing OVHR that require CS or PAN have a higher independent risk of complications, which increases when the procedures are combined.

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Gluteal Fascial Advancement for Pilonidal Cyst Disease: A 10-year Review

The American Surgeon ◽

10.1177/000313481608200728 ◽

2016 ◽

Vol 82 (7) ◽

pp. 622-625 ◽

Cited By ~ 1

Author(s):

Benjamin C. Powell ◽

Colin B. Webb ◽

Joseph A. Ewing ◽

Dane E. Smith

Keyword(s):

Primary Closure ◽

Wound Closure ◽

High Rate ◽

Wound Complications ◽

Simple Closure ◽

Cyst Excision ◽

Novel Technique ◽

Pilonidal Cyst ◽

Wound Breakdown ◽

Advancement Flaps

Elective excision of noninfected pilonidal cysts has historically been plagued by a high rate of complications, such as wound breakdown and recurrence. Debate remains regarding the most effective method of wound closure. We previously reported a small group of patients (n = 17 out of 83 patients) in which a novel technique decreased wound complications and recurrence. The purpose of this article was to build on that prior study by evaluating the utility of the gluteal fascial advancement method to decrease complications over a 10-year period. All patients who underwent elective pilonidal cyst excision from 2008 to 2015 were retrospectively reviewed (n = 150); this was added to the data from 2004 to 2007. Patients were divided into two cohorts: those who underwent elective excision with simple closure (n = 172) and those who underwent bilateral gluteal fascial advancement flaps (n = 61). Primary end points included recurrence and dehiscence. Overall demographic characteristics were statistically comparable between groups. The rate of recurrence was not significantly different between groups. However, wound closure using bilateral gluteal fascial advancement flaps was associated with a significantly lower rate of dehiscence when compared with standard primary closure (12% vs 40%, P < 0.001). The use of bilateral gluteal fascial advancement flaps is a superior method for closing elective pilonidal cyst excisions.

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The effect of increasing body mass index on wound complications in open ventral hernia repair with mesh

The American Journal of Surgery ◽

10.1016/j.amjsurg.2019.01.022 ◽

2019 ◽

Vol 218 (3) ◽

pp. 560-566 ◽

Cited By ~ 9

Author(s):

Luciano Tastaldi ◽

David M. Krpata ◽

Ajita S. Prabhu ◽

Clayton C. Petro ◽

Steven Rosenblatt ◽

...

Keyword(s):

Body Mass Index ◽

Hernia Repair ◽

Ventral Hernia ◽

Body Mass ◽

Ventral Hernia Repair ◽

Wound Complications ◽

Open Ventral Hernia Repair

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Topical antiseptic mouthwash in oncological surgery of the oral cavity and oropharynx

The Journal of Laryngology & Otology ◽

10.1017/s0022215100128658 ◽

1994 ◽

Vol 108 (11) ◽

pp. 973-979 ◽

Cited By ~ 15

Author(s):

Miriam I. Redleaf ◽

Carol A. Bauer

Keyword(s):

Oral Cavity ◽

Head And Neck ◽

Oral Presentation ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Wound Complications ◽

University Of Iowa ◽

Wound Breakdown ◽

Oral Preparation ◽

Operative Wound

AbstractA multivariant analysis of the value of the use of a pre-operative topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in 106 consecutive patients undergoing head and neck surgery involving the oral cavity or oropharynx was carried out at the University of Iowa, Department of Otolaryngology-Head and Neck Surgery. An oral presentation employing povidone–iodine solution was used for 43 patients. The remaining 63 patients studied received no oral presentation. Unfavourable wound outcome was not associated with age, sex, presence and condition of teeth, or serious pre-existing medical illnesses. A significant correlation was found between post-operative wound breakdown and type of closure, stage of disease, and previous operation or radiotherapy. The use of an oral preparation correlated significantly with favourable wound outcome independent of all other variables (p<0.01).Our data support the use of a topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in surgery of the oral cavity and oropharynx.

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