scholarly journals Usefulness of a needleless suture technique for midline laparotomy wound dehiscence: a case report

2021 ◽  
Vol 6 (1) ◽  
pp. 22-24
Author(s):  
Da Yeon Lee ◽  
Pil Young Jung
Keyword(s):  
Wound Healing ◽  
Case Report ◽  
Wound Dehiscence ◽  
Cost Effective ◽  
Suture Technique ◽  
Surgical Wound ◽  
Midline Laparotomy ◽  
Surgical Wound Dehiscence ◽  
Surgical Incisions ◽  
Laparotomy Wound

Surgical wound dehiscence after a laparotomy is a serious complication, and it presents the mechanical wound healing failure of surgical incisions. Since the development of needleless suture techniques, there have been attempts to use a needleless suture for wounds from several surgery types. Recently, many studies have shown that a needleless suture technique leads to good wound healing results. It is rapid, cost effective, can minimize ventilator dependency, and is well tolerated by patients. Here, we report a case of a patient who received a needleless suture technique for midline laparotomy wound dehiscence.

scholarly journals Management of surgical wound dehiscence by oxygen-ozone therapy in a FIV-positive cat – a case report

2020 ◽  
Vol 89 (2) ◽  
pp. 189-194
Author(s):  
Călin Cosmin Repciuc ◽  
Corina Gina Toma ◽  
Ciprian Andrei Ober ◽  
Liviu Ioan Oana
Keyword(s):  
Case Report ◽  
Wound Dehiscence ◽  
Complete Healing ◽  
Limb Amputation ◽  
X Rays ◽  
Surgical Wound ◽  
Ozone Therapy ◽  
Contraction Phase ◽  
Surgical Wound Dehiscence ◽  
Low Efficiency

Patients infected with the feline immunodeficiency virus (FIV) are frequently victims of postoperative wound dehiscence due to low efficiency of the immune system that predisposes to delayed scaring and epithelization processes. This case report aimed to describe the successful use of medical ozone in the treatment of a dehisced wound in a feline patient that presented this type of FIV-associated complication. Here we present a case of a 12-year-old, mixed-breed, male, FIV-positive cat with purulent arthritis affecting the shoulder, elbow, and the carpal joints with subsequent periostitis and arthrogryposis affecting the right forelimb. After a thorough investigation (clinical examination, X-rays) it was decided that limb amputation would be the proper choice. The surgical wound did not tend to heal, followed by rejection of the suture material, skin necrosis, and wound dehiscence. After 13 days following the surgery with allopathic treatment and no improvement, oxygen-ozone-therapy was started. Clinically, oxygen-ozone therapy showed significant results after the first session: borders of the wound got into the contraction phase, got attached to the underlying tissues, and exudates were significantly diminished. The therapy continued every 2 days showing improved blood perfusion of the affected area and a visible advancement of the contraction phase daily with complete healing in 1.5 months.

Surgical Wound Dehiscence Treatment With Low-Level Laser Therapy and Barbatimão: A Case Report

2021 ◽  
Vol 67 (10) ◽  
pp. 18-22
Author(s):  
Jessica Breder ◽  
Daniela Tsukumo ◽  
Eliana Pereira ◽  
Maria Lima
Keyword(s):  
Case Report ◽  
Laser Therapy ◽  
Wound Dehiscence ◽  
Low Level Laser Therapy ◽  
Surgical Wound ◽  
Low Level ◽  
Low Level Laser ◽  
Surgical Wound Dehiscence ◽  
Level Laser

BACKGROUND: Low-level laser therapy (LLLT) and a gel containing an extract of Barbatimão, a native Brazilian tree, have shown promising results in both preclinical and clinical wound healing studies. PURPOSE: To describe the treatment of surgical wound dehiscence with LLLT and Barbatimão gel. CASE STUDY: A 54-year-old woman without comorbidities underwent abdominoplasty at another health facility. Three (3) weeks later she presented to the authors’ clinic after an episode of syncope, abrupt dyspnea, purulent exudate, and necrotic tissue in the surgical incision. She reported that wound redness, warmth, and swelling started 8 days postoperatively. The patient was admitted; on day 3 of that hospital stay, her condition improved and surgical debridement was performed. Follow-up care of wound dehiscence was provided in the outpatient clinic. The treatment involved daily application of Barbatimão gel and weekly application of LLLT. The wound healed after 84 days. CONCLUSION: This case report suggests that LLLT may be a beneficial adjunctive therapy, together with Barbatimão gel, for the treatment of surgical wound dehiscence.

scholarly journals Early versus late dressing removal in clean and contaminated midline laparotomy wounds: a non-randomized pilot study

2018 ◽  
Vol 5 (9) ◽  
pp. 3051
Author(s):  
Vijayakumar C. ◽  
Prabhu R. ◽  
Muthukrishnan V. ◽  
Kalaiarasi R. ◽  
Swetha T.
Keyword(s):  
Wound Healing ◽  
Wound Dehiscence ◽  
Final Analysis ◽  
Early Discharge ◽  
Midline Laparotomy ◽  
Early Removal ◽  
Deep Surgical Site Infection ◽  
Laparotomy Wound ◽  
Complete Wound Healing ◽  
Removal Group

Background: This study was carried out to evaluate the efficacy of early versus late dressing removal in clean and contaminated midline laparotomy wounds.Methods: Fifty patients aged ≥18 years who were admitted and operated for surgical procedures (both emergency and elective) were included in the study. All laparotomy wounds had fulfilled the CDC criteria.  Twenty-five patients each were included in early dressing removal group and the late removal group. In early removal group, the laparotomy wound dressing was removed within 48 hours and in late removal group, was removed after 48 hours of surgery. The incidences of superficial and deep surgical site infection (SSI) in both groups were analysed. Other secondary parameters like incidence of wound dehiscence and secondary suturing were also analysed.Results: Twenty-five patients each, in early removal group and in late removal group were included for final analysis. The incidence of superficial SSI (%) was significantly less in early removal group (65.50 versus 89.50; p= <0.001). The duration (days) required for complete wound healing (8.52 versus 10.65; p=0.734) was significantly less in the early removal group. The length of postoperative hospital stay (days) was significantly less in early removal group (10.30 versus 14.90; p= <0.001).Conclusions: Early removal of dressing significantly reduces the incidence of superficial SSI in midline clean and contaminated laparotomy wounds. It also significantly reduces the duration required for complete wound healing and facilitates early discharge of the patient compared to late dressing removal.

scholarly journals Tensile reduction sutures for surgical wound dehiscence in an obese patient^|^mdash;a case report^|^mdash;

2012 ◽  
Vol 73 (10) ◽  
pp. 2730-2733
Author(s):  
Ai MURAKI ◽  
Shuhei TORII ◽  
Akihiro HORI ◽  
Jun MORIOKA ◽  
Kiyotaka KAWAI ◽  
...  
Keyword(s):  
Case Report ◽  
Obese Patient ◽  
Wound Dehiscence ◽  
Surgical Wound ◽  
Surgical Wound Dehiscence

Comparison of Laparotomy Wound Dehiscence (LWD) Rate Using Interrupted X-Suture Technique vs Continuous Suture Technique in Rectus Sheath in Emergency Laparotomy

1969 ◽  
Vol 11 (3) ◽  
pp. 133-136
Author(s):  
Fazli Akbar ◽  
Muhammad Khan ◽  
Nisar Ahmad ◽  
Shah Abbas ◽  
Nadeem Khan
Keyword(s):  
Rectus Sheath ◽  
Wound Dehiscence ◽  
Suture Technique ◽  
P Value ◽  
Emergency Laparotomy ◽  
Continuous Suture ◽  
Midline Laparotomy ◽  
Group I ◽  
Laparotomy Wound ◽  
Group Ii

Background: Emergency laparotomy is one of the most commonly performed surgeries in emergency situations of generalsurgery department. This can be performed for multiple causes. Wound closure is one of the main component of outcomes of thissurgery. Some surgeons prefer continuous closure ofthe linea Alba while other prefer interrupted closure technique.Objective: To compare the frequency of laparotomywound dehiscence (LWD) using continuous suture technique with interruptedX-suture technique inrectus sheath for emergency laparotomy wound closure.Materials & Methods: This randomized controlled trial was conducted on adult patients who were planned for emergency midlinelaparotomy in the department of general surgery of Saidu Group of Teaching Hospitals, Swat. The study was conducted fromJanuary 2019 to November 2019. We included 200 patients and divided them into two equal groups. Group I; In these patients,abdominal incision was closed using continuous suture technique.Group II; inthese patients, interrupted X-suture technique wasused for closure of abdominal wound incision. Patients were evaluated daily for 7 days and after that, at 15, h day, to diagnose thewound dehiscence on clinical evaluation.Results:Mean age was 43.8 ± 8.7 years in group I and42.6 ± 10.9 years in groupII(p-value 0.39). There were 77%male patients ingroup I and 74% in group II (p-value 0.74). Peritonitis due to gut perforation was the commonest etiology, with 63% proportion ingroup I versus 68% in group II (p-value 0.55). Laparotomy wound dehiscence was diagnosed in 15% patients in group I versus3.0% patients in group II (p-value 0.006).Conclusion: Interrupted X-suture technique is better than continuous suture technique for abdominal wall closure afteremergency midline laparotomy.Interrupted X-suture technique has significantly loweredthe frequency of wound dehiscence.Keywords:Acute abdomen, emergency midline laparotomy,laparotomy wound dehiscence.

scholarly journals Placentrex gel used as a surgical wound healing agent: A case report

2021 ◽  
Vol 7 (2) ◽  
pp. 366-369
Author(s):  
Dr. Aditya Sharma ◽  
Dr. Mayur Kaushik ◽  
Dr. Nazar Rana ◽  
Dr. Soundarya Singh
Keyword(s):  
Wound Healing ◽  
Case Report ◽  
Surgical Wound ◽  
Healing Agent

The Perth Surgical Wound Dehiscence Risk Assessment Tool (PSWDRAT): development and prospective validation in the clinical setting

2019 ◽  
Vol 28 (6) ◽  
pp. 332-344 ◽  
Author(s):  
Kylie Sandy-Hodgetts ◽  
Keryln Carville ◽  
Nick Santamaria ◽  
Richard Parsons ◽  
Gavin D. Leslie
Keyword(s):  
Risk Assessment ◽  
Predictive Power ◽  
Assessment Tool ◽  
Wound Dehiscence ◽  
Risk Assessment Tool ◽  
Anatomical Location ◽  
Surgical Wound ◽  
Previous Surgery ◽  
Postoperative Wound ◽  
Surgical Wound Dehiscence

Objective:The worldwide volume of surgery today is considerable and postoperative wound healing plays a significant part in facilitating a patient's recovery and rehabilitation. While contemporary surgical procedures are relatively safe, complications such as surgical wound dehiscence (SWD) or breakdown of the incision site may occur despite advances in surgical techniques, infection control practices and wound care. SWD impacts on patient mortality and morbidity and significantly contributes to prolonged hospital stay. Preoperative identification of patients at risk of SWD may be valuable in reducing the risk of postoperative wound complications.Method:A three-phase study was undertaken to determine risk factors associated with SWD, develop a preoperative patient risk assessment tool and to prospectively validate the tool in a clinical setting. Phases 1 and 2 were retrospective case control studies. Phase 1 determined variables associated with SWD and these informed the development of a risk assessment tool. Univariate analysis and multiple logistic regression were applied to identify predictors of surgical risk. Phase 2 used the receiver operator curve statistic to determine the predictive power of the tool. Phase 3 involved a prospective consecutive case series validation to test the inter-rater reliability and predictive power of the tool.Results:In addition to those already identified in the literature, one independent risk predictor for SWD was identified: previous surgery in the same anatomical location (p<0.001, odds ratio [OR] 4). Multiple combined factors were integrated into the tool and included: age (p<0.019, OR 3), diabetes (p<0.624, OR 2), obesity (p<0.94, OR 1.4), smoking (p<0.387, OR 2), cardiovascular disease (p<0.381 OR 3) and peripheral arterial disease (p<0.501, OR 3). The predictive power of the tool yielded 71% in a combined data sample.Conclusion:Patients with previous surgery in the same anatomical location were four times more likely to incur a dehiscence. Identification of at-risk patients for complications postoperatively is integral to reducing SWD occurrence and improving health-related outcomes following surgery.

Influence of suture technique on laparotomy wound healing: an experimental study in the rat

2001 ◽  
Vol 386 (3) ◽  
pp. 218-223 ◽  
Author(s):  
Jörg Höer ◽  
Uwe Klinge ◽  
Alexander Schachtrupp ◽  
Christian Töns ◽  
Volker Schumpelick
Keyword(s):  
Experimental Study ◽  
Wound Healing ◽  
Suture Technique ◽  
Laparotomy Wound

scholarly journals A comparative study between continuous and x-interrupted sutures in emergency midline laparotomies

2018 ◽  
Vol 5 (5) ◽  
pp. 1753
Author(s):  
Shashikala V. ◽  
Abhilash S. B. ◽  
Abhishek G. ◽  
Prajwal S. Fernandes
Keyword(s):  
Suture Material ◽  
Rectus Sheath ◽  
Surgical Site Infections ◽  
Wound Dehiscence ◽  
Midline Laparotomy ◽  
Group A ◽  
Common Technique ◽  
Laparotomy Wound ◽  
Group B ◽  
Time Required

Background: Midline laparotomy is the most common technique of abdominal incisions in both emergency and elective settings. Wound dehiscence is related to several factors pertaining to patient besides suture material and method of closure. This study tries to compare continuous sutures with x-interrupted sutures in mass closure of midline laparotomy wound in patients undergoing emergency midline laparotomy for acute peritonitis.Methods: A total of 60 patients undergoing emergency midline laparotomy for secondary peritonitis were considered for the study, 30 of whom underwent closure of abdominal wall with continuous sutures (Group A) and the other 30 with x-interrupted sutures (Group B) using non-absorbable, monofilament, polypropylene suture. Necessary preoperative data, the time required for rectus closure, length of the suture material required, post-operative complications like surgical site infection, wound dehiscence were analyzed.Results: The groups were comparable in means of age and sex distribution. Group A was found to have lesser time for closure of rectus, lesser suture length and lesser suture to wound length ratio when compared with Group B. Surgical site infections were similar in both groups. Patients with rectus sheath sutured in x-interrupted sutures (n=2) had significantly less wound dehiscence as compared with continuous sutures (n=8) (p<0.05).Conclusions: Interrupted -X suture method of suturing reduces post-operative wound dehiscence, although requires more suture and consumes more time than the continuous method of suturing.

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