SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Wound dehiscence

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Treatment guidelines for abdominal wound dehiscence (WD) are lacking. The primary aim of the study was to compare suture to mesh repair in WD patients concerning incisional hernia incidence. Secondary aims were to compare recurrent WD, morbidity, mortality and long-term abdominal wall complaints.

Concepts: Comparison, Primary education, Comparisons, Dehiscence, Wound dehiscence

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Wound dehiscence and SSI’s can have a profound impact on patients, as they often require hospital re-admission, additional surgical interventions, lengthy IV antibiotic administration and delayed rehabilitation. Negative pressure wound therapy(NPWT) exposes the wound site to negative pressure, resulting in the improvement of blood supply, removal of excess fluid and stimulation of cellular proliferation of granulation tissue.

Concepts: Immune system, Blood, Wound healing, Hospital, Infection, Chronic wound, Negative pressure wound therapy, Wound dehiscence

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Wound dehiscence and incisional hernia are potentially serious complications following abdominal surgery, especially if performed through a midline incision. Although prophylactic reinforcement with on-lay mesh has been shown to reduce this risk, a permanent mesh carries the risk of seroma formation, infection, and persistent pain. The aim of this study was to assess the safety of a reabsorbable on-lay mesh to reinforce the midline suture in patients with high risk for wound dehiscence or incisional hernia.

Concepts: Surgery, English-language films, American films, Reinforcement, Laparotomy, Dehiscence, Wound dehiscence

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Wound healing problems are the most common complication after open reduction with internal fixation (ORIF) of unstable ankle fractures. The incidence is especially high among elderly patients with medical comorbidities and patients with compromised soft tissues. Minimally invasive plate osteosynthesis (MIPO) might provide a safer alternative to ORIF by preventing extensive soft tissue dissection and preserving the blood supply. We conducted a retrospective review of 44 consecutive patients who had undergone MIPO of unstable ankle fractures. All patients had a minimum 1-year follow-up (mean 82 weeks); 80% were aged ≥60 years, 52% had diabetes, and 45% had a compromised soft tissue envelope. Immediate postoperative radiographs were evaluated for the quality of reduction, and clinical records were analyzed for the complication rate. Good to excellent anatomic reduction was achieved in 89% of the patients. The overall complication rate was 27%, including 25% surgical wound dehiscence, 9% infection, and 11% loss of reduction. No patient experienced nerve injury. Those with a history of ankle fracture dislocation and a compromised soft tissue envelope preoperatively had a significantly greater incidence of surgical wound dehiscence and complications overall compared with those without (p = .016 and p = .035; p = .045 and p = .009, respectively). Peripheral vascular disease was a statistically significant predictor of surgical wound dehiscence (p = .010). The overall complication rate in our study was comparable to that seen in similar populations treated with conventional ORIF. In conclusion, our results suggest that MIPO in high-risk patients is a safe alternative, with predictable outcomes, comparable to those of traditional open techniques.

Concepts: Medicine, Surgery, Physician, Tissues, Soft tissue, Human anatomy, Ankle, Wound dehiscence

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The free anterolateral thigh (ALT) flap has been widely used for various kinds of reconstructions. However, delayed healing at the donor site occasionally occurs due to wound dehiscence or the partial loss of grafted skin at the donor site. The aim of the present study was to identify reliable predictive factors for delayed healing at the donor site after the harvest of a free ALT flap.

Concepts: Present, Time, Wound healing, Future, Dehiscence, Wound dehiscence

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Surgical site infection (SSI) is a common complication of gastrointestinal surgery. Because retention suture is known to prevent abdominal wound dehiscence, it is only considered indicated in high-risk patients. At present, there are no clear indications for retention suture. The purpose of this study was to analyze the effect of prophylactic retention suture and to determine what situations indicate prophylactic retention suture against SSI.

Concepts: Cohort study, Surgery, Antiseptic, Wound dehiscence

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Negative pressure wound therapy with instillation (NPWTi) has been proved to be a safe and effective treatment option for abdominal wall wound dehiscence with mesh exposure. Our aim in this study is to examine whether it is also cost-effective.

Concepts: Photography, Vacuum, Negative pressure wound therapy, Dehiscence, Wound dehiscence, AIM Investment Management

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Contaminated abdominal fascial defects, such as those seen in enterocutaneous fistula, or wound dehiscence with mesh exposure, are a significant source of morbidity and present unique reconstructive challenges. We present our technique of using the fascia lata, augmented with an interpositional omental flap, for complete autologous reconstruction of contaminated fascial defects, and the postoperative results of 3 cases.

Concepts: Fistula, Fascia, Dehiscence, Wound dehiscence, Deep fascia

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In 1975, Evans published an article describing the surgical management of the “calcaneo-valgus deformity,” pointing out that the deformity was due to relative shortening of the lateral column of the foot. Correction involved “equalizing” both columns by performing an osteotomy in the neck of the calcaneus 1.5 cm from the calcaneocuboid joint, where a trapezoidal wedge of tricortical bone was placed. Although it was considered a success, there were complications, including sural nerve injury, surgical wound dehiscence, undercorrection, and graft subsidence. The osteotomy grew in popularity. Indications extended to other forms of flatfoot with a low incidence of complications.

Concepts: Surgery, Foot, Injury, Orthopedic surgery, Oral and maxillofacial surgery, Sural nerve, Arches of the foot, Wound dehiscence

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Wound dehiscence is one of the most common complications of surgical ulcer, involving the breaking open of the surgical incision along the stitch. This condition is a severe complication of total knee arthroplasty.

Concepts: Surgery, Knee replacement, Dehiscence, Wound dehiscence