scholarly journals Successful Management of Abdominal Wound Dehiscence with Bogota bag, Vacuum assisted Closure combined with Tension Sutures

2021 ◽  
Vol 4 (7) ◽  
pp. 01-04
Author(s):  
Abeysinghe AHMGB ◽  
Senarathne R ◽  
Wimalasena GADNB
Keyword(s):  
Wound Dehiscence ◽  
Morbidly Obese ◽  
Vacuum Assisted Closure ◽  
Successful Management ◽  
Burst Abdomen ◽  
Local Infiltration ◽  
Abdominal Wound Dehiscence ◽  
Morbid Obese ◽  
Large Wound ◽  
Tissue Oedema

The burst abdomen management has advanced significantly. Here we present a management of a burst abdomen of morbid obese patient with combination of modality including Bogota bag, vacuum assisted closure and tension suturing. The patient underwent laparotomy for removal of sigmoid tumor with local infiltration and had wound dehiscence associated with infection, tissue oedema and necrosis. As patient was morbidly obese and had large wound gap, we decided to manage it with Bogota bag principal and Vacuum Assisted Closing. After successful formation of granulation tissue, we were able to apply tension sutures. Hence using combination of above-mentioned options, the patient was successfully sent back to his normal routines without any complication.

scholarly journals Successful management of abdominal wound dehiscence using a vacuum assisted closure system combined with mesh-mediated medial traction

2015 ◽  
Vol 97 (1) ◽  
pp. e3-e5 ◽  
Author(s):  
AC Lord ◽  
R Hompes ◽  
A Venkatasubramaniam ◽  
S Arnold
Keyword(s):  
Abdominal Wall ◽  
Primary Closure ◽  
Open Abdomen ◽  
Wound Dehiscence ◽  
Fascial Closure ◽  
Abdominal Wound ◽  
Closure System ◽  
Vacuum Assisted Closure ◽  
Successful Management ◽  
Abdominal Wound Dehiscence

Management of the open abdomen has advanced significantly in recent years with the increasing use of vacuum assisted closure (VAC) techniques leading to increased rates of fascial closure. We present the case of a patient who suffered two complete abdominal wall dehiscences after an elective laparotomy, meaning primary closure was no longer possible. She was treated successfully with a VAC system combined with continuous medial traction using a Prolene®mesh. This technique has not been described before in the management of patients following wound dehiscence.

Vacuum-Assisted Closure for Abdominal Wound Dehiscence with Prosthesis Exposure in Hernia Surgery

2003 ◽  
Vol 112 (4) ◽  
pp. 1188-1189 ◽  
Author(s):  
Axel de Vooght ◽  
Guy Feruzi ◽  
Roger Detry ◽  
Jan Lerut ◽  
Romain Vanwijck
Keyword(s):  
Wound Dehiscence ◽  
Abdominal Wound ◽  
Vacuum Assisted Closure ◽  
Hernia Surgery ◽  
Abdominal Wound Dehiscence

scholarly journals Study of burst abdomen: it’s causes and management

2018 ◽  
Vol 5 (3) ◽  
pp. 1035 ◽  
Author(s):  
N. K. Jaiswal ◽  
Sandeep Shekhar
Keyword(s):  
Significant Risk ◽  
Wound Dehiscence ◽  
Clinical History ◽  
Duodenal Perforation ◽  
Abdominal Wound ◽  
Burst Abdomen ◽  
Impaired Wound Healing ◽  
Hospitalised Patients ◽  
Abdominal Wound Dehiscence ◽  
The Impact

Background: Burst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Burst abdomen is defined  as post-operative separation of abdominal musculo-aponeurotic layers.  The  study aims to find etiological factors of burst abdomen in hospitalised patients ,evaluate current management  methods and to compare conservative and operative approach with respect to complication and outcomes.Methods: All cases presenting with abdominal wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed , type of disease involved and management methods and their outcome. A total of 82 cases were included in this prospective study. Data was analysed using appropriate software.Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5th decade. Patients presenting with peritonitis secondary to gastro-duodenal perforation are more prone to burst abdomen.Conclusions: Burst abdomen is a serious sequel of impaired wound healing. Presence of anaemia,  hypoproteinemia favours high incidence of burst abdomen. Delayed suturing,  of burst abdomen has a lower frequency of complications . Adherence to proper technique and sincere efforts to minimize the impact of the predisposing factors play a much larger role in both treatment and prevention of this condition. 

scholarly journals Competition Test Veteran Affairs Medical Centre (VAMC) Score and KIMS-14 for Predicting the Dehiscence of Abdoment Post Laparotomy Operating Wounds

2020 ◽  
Vol 3 (1) ◽  
pp. 11-22
Author(s):  
Reza Akmal ◽  
Efman EU Manawan ◽  
Mgs Irsan Saleh
Keyword(s):  
Area Under Curve ◽  
Wound Dehiscence ◽  
Abdominal Wound ◽  
Burst Abdomen ◽  
Death Rates ◽  
Digestive Surgery ◽  
Veteran Affairs ◽  
Test Study ◽  
Abdominal Wound Dehiscence ◽  
Significant Mortality

Introduction. Abdominal wound dehiscence (AWD) is a complication of severe postoperative abdominal surgery, with reported death rates ranging from 10% to 45%. Significant mortality, prolonged hospitalization, increased incidence of incisional hernias and reoperations for ruptured stomachs, with costs associated with the community, emphasize the severity of these complications. The VAMC score and KIMS-14 can be used as screening in predicting surgical injury dehiscence Method.This study is a diagnostic test study to assess the sensitivity and specificity of VAMC and KIMS-14 scoring in predicting the occurrence of abdominal wound dehiscence to be performed in surgery outpatient and digestive surgery ward at the General Hospital, Dr. Mohammad Hoesin Palembang in the period March to May 2019.Results. There were 44 subjects that participated in this study. VAMC has a sensitivity value of 87.5% and specificity of 97.2 with an area under curve value of 0.958 with a cut-off of  10. KIMS 14 has a sensitivity value of 100% and a specificity of 94.4% with an area under curve value of 0.944 with a cut-off of  5.Conclusion: KIMS-14 is better in sensitivity, but VAMC is more specific to predict dehiscence licensing in patients undergoing intraabdominal surgery.Keywords: VAMC, KIMS-14, abdominal wound dehiscence, post-laparotomy, mortality, burst abdomen.

scholarly journals Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice

Medicinus ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 102
Author(s):  
Gezta Nasafir Hermawan ◽  
Jacobus Jeno Wibisono ◽  
Lidya F Nembo
Keyword(s):  
Risk Factors ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Health Centers ◽  
Obstetrics And Gynecology ◽  
Abdominal Wound ◽  
Burst Abdomen ◽  
Incidence And Mortality ◽  
Complete Disruption ◽  
Abdominal Wound Dehiscence

<p>Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.</p>

scholarly journals Ether-Based Polyurethane Foam for Vacuum-Assisted Closure (V.A.C.) of Complicated Postoperative Abdominal Wound Dehiscence

2019 ◽  
Vol 57 (2) ◽  
pp. 32-38
Author(s):  
Aida Petca ◽  
Silvius Negoita ◽  
Razvan-Cosmin Petca ◽  
Oana Calo ◽  
Ruxandra Diana Sinescu
Keyword(s):  
Wound Repair ◽  
Negative Pressure Wound Therapy ◽  
Wound Dehiscence ◽  
Antimicrobial Effect ◽  
Silver Layer ◽  
Abdominal Wound ◽  
Vacuum Assisted Closure ◽  
Wound Therapy ◽  
Abdominal Wound Dehiscence ◽  
Secondary Closure

Background. The macroporous polyurethane ether foam was introduced in the medical field, as early as the 90 ties, for the Vacuum-assisted closure (V.A.C.) of a wound. We describe our experience after treating abdominal wound dehiscence in a group of elderly gynecological patients with NPWT (Negative Pressure Wound Therapy), using ether foam coated with a silver layer. We reviewed elderly patients chart data that underwent abdominal surgery complicated with wound dehiscence treated with VAC for eighteen months. In all patients, the system used was the standard GranuFoam Silver™ dressing (different extents), which was usually replaced every 48/72 h. A total of 15 consecutive female patients were included. The median age was 67.3 (58-71) years. Duration of VAC treatment was median 14.2 (11-34) days, and we saw an improvement in wound repair but also clearance of S.S.I. on the third day after applying V.A.C. Ulta™. Definitive secondary closure of the wound was obtained in all patients, as the infection�s site clearance. The abdominal VAC treatment with GranuFoam Silver™ dressing in patients with infected abdominal wound dehiscence is safe and has proper patient compliance. The latest evolution of the silver foam polyether dressing, in conjunction with NPWT therapy, offers a better antimicrobial effect and shorter healing stage.

scholarly journals Ether-Based Polyurethane Foam for Vacuum-Assisted Closure (V.A.C.) of Complicated Postoperative Abdominal Wound Dehiscence

2019 ◽  
Vol 57 (2) ◽  
pp. 239-252
Author(s):  
Aida Petca ◽  
Silvius Negoita ◽  
Razvan-Cosmin Petca ◽  
Oana Calo ◽  
Ruxandra Diana Sinescu
Keyword(s):  
Wound Repair ◽  
Negative Pressure Wound Therapy ◽  
Wound Dehiscence ◽  
Antimicrobial Effect ◽  
Silver Layer ◽  
Abdominal Wound ◽  
Vacuum Assisted Closure ◽  
Wound Therapy ◽  
Abdominal Wound Dehiscence ◽  
Secondary Closure

Background. The macroporous polyurethane ether foam was introduced in the medical field, as early as the 90 ties, for the Vacuum-assisted closure (V.A.C.) of a wound. We describe our experience after treating abdominal wound dehiscence in a group of elderly gynecological patients with NPWT (Negative Pressure Wound Therapy), using ether foam coated with a silver layer. We reviewed elderly patients chart data that underwent abdominal surgery complicated with wound dehiscence treated with VAC for eighteen months. In all patients, the system used was the standard GranuFoam Silver™ dressing (different extents), which was usually replaced every 48/72 h. A total of 15 consecutive female patients were included. The median age was 67.3 (58-71) years. Duration of VAC treatment was median 14.2 (11-34) days, and we saw an improvement in wound repair but also clearance of S.S.I. on the third day after applying V.A.C. Ulta™. Definitive secondary closure of the wound was obtained in all patients, as the infection�s site clearance. The abdominal VAC treatment with GranuFoam Silver™ dressing in patients with infected abdominal wound dehiscence is safe and has proper patient compliance. The latest evolution of the silver foam polyether dressing, in conjunction with NPWT therapy, offers a better antimicrobial effect and shorter healing stage.

Hand-assisted laparoscopic nephrectomy in morbidly obese patients

2020 ◽  
Vol 99 (6) ◽  
pp. 271-276
Keyword(s):  
Body Weight ◽  
Surgical Technique ◽  
Blood Loss ◽  
Hospital Stay ◽  
Kidney Cancer ◽  
The Body ◽  
Laparoscopic Nephrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

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