A Study of subcutaneous negative pressure closure versus simple closure in laparotomy wound of Ileal perforation
Journal Title: International Journal of Medical Science and Public Health - Year 2014, Vol 3, Issue 1
Abstract
Background: Ileal perforation is a surgical emergency. It has very high morbidity and also mortality. As patients are commonly presented with peritonitis and fecal contamination, wound infection rate is very high. Wound infection is major issue in such condition, where related complications are frequently seen. If wound infection is controlled then many complication related to it could be prevented. And it finally affects the morbidity of patient. Aims & Objective: To compare a role of negative pressure closure versus simple closure of laparotomy wound in ileal perforation. Material and Methods: 60 cases, in period of Nov 2012 to June 2013 at SMIMER hospital, Surat presented with ileal perforation were included in the study. After a surgical treatment of all cases, they were divided in two groups. One group A was closed with Negative pressure closure (By putting subcutaneous Negative Suction Drain) at the time of laparotomy wound closure and other group B with simple closure. And the outcome compared in the form of wound infection, hospital stay, second surgery and morbidity. Total 10 cases were expired within 3 day after surgery, excluded from study (6 from group A and 4 from group B). Results: In study average rate of wound infection (SSI-Surgical Site Infection) was 25% (8/24) in group A and 57.7% (15/26) in group B. Average hospital stay for group A was 12 day and 18 day for group B. Second surgery needed in 4 cases in group A and for 8 cases in group B. Second surgery was in form of secondary suturing of wound or wound dehiscence and burst abdomen repair. Mortality in group A was 6 and in group B was 4 but it was not related to SSI because all death occurred within 3 days after surgery mainly due delay presentation and to poor general condition pre-operatively. Overall morbidity was less with Negative pressure closure in compare to simple closure and it highly affects the morbidity and somehow mortality also. Conclusion: One of the common complications of typhoid is typhoid ulcer and perforation. There is more chance of wound infection in such laparotomy wound because of highly contamination of the peritoneal fluid with fecal material. Such wound constantly leads to serous discharge and bacterial colonization. But negative pressure closure removes that collection and avoids wound infection. And it helps in reducing hospital stay and morbidity
Authors and Affiliations
Yagnesh Vaghani, Jeeten Chaudhri, Sudhir Navadiya
Keywords
Related Articles
- EP ID EP158756
- DOI 10.5455/ijmsph.2013.200920131
- Views 65
- Downloads 0
An analytical study of number, position, size and direction of nutrient foramina of femur
Background: Bones are structures that adapt to their mechanical environment and from a fetal age also adapt to the presence of naturally occurring holes called as nutrient foramina, which are narrow tunnels that c...
A study of the utility of lactate dehydrogenase, total proteins, and adenosine deaminase in the diagnosis of pleural exudates: A new statistical approach
Background: Pleural fl uid (PF) may be transudative or exudative. Total protein estimation from PF is used to detect exudative pleural effusion. Objectives: To determine the role of new suggested criteria consistin...
An update on growth and development of telemedicine with pharmacological implications
Telemedicine is an application of information technology in relation to patient health care, treatment, education, research, administration and the public health. It forms a potential bridge between the patient an...
Older paternal age and positive consanguinity increase the burden of β thalassemia disease
Background: β thalassemia has been considered one of the most common genetic diseases. It represents public health concern especially in Middle East and Mediterranean regions. Objective: To determine the influenti...
Pyogenic liver abscesses and symptomatic hypercalcemia: The report of an unusual association
Hypercalcemia is usually caused by primary hyperparathyroidism or malignancy, a number of other conditions can be important to consider. Of the infectious causes of hypercalcemia described in the literature Staphylococcu...