Surgical Management of Sternal Wound Dehiscence

2018 ◽  
pp. 251-261 ◽  
Author(s):  
Maria Pia Tocco ◽  
Eugenio Pompeo ◽  
Giovanni Ruvolo
Keyword(s):  
Surgical Management ◽  
Wound Dehiscence ◽  
Sternal Wound Dehiscence

scholarly journals Impact of vacuum-assisted closure therapy on outcomes of sternal wound dehiscence

2014 ◽  
Vol 19 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Vincenzo Tarzia ◽  
Massimiliano Carrozzini ◽  
Giacomo Bortolussi ◽  
Edward Buratto ◽  
Jonida Bejko ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Vacuum Assisted Closure ◽  
Sternal Wound Dehiscence ◽  
Vacuum Assisted Closure Therapy

scholarly journals OV09 ROBOTIC REPAIR OF SUBXIPHOID INCISIONAL HERNIA POST CABG

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Moamena El-Matbouly ◽  
Yaser Janahi ◽  
Ahmed Suliman ◽  
Hany Atalah ◽  
Ahmed Albahrani
Keyword(s):  
Incisional Hernia ◽  
Abdominal Wall ◽  
Complex Structure ◽  
Median Sternotomy ◽  
Wound Dehiscence ◽  
High Recurrence Rate ◽  
Linea Alba ◽  
Prolonged Intubation ◽  
Sternal Wound Dehiscence ◽  
Upper Abdominal

Abstract Aim A median sternotomy that extends toward the epigastric area can weaken the upper abdominal wall and result in the development of subxiphoid incisional hernia. We aim to assess the efficacy and the feasibility of repair of subxiphoid incisional hernia post CABG robotically. In this video; we will also review the surgical technique and the steps for robotic repair of subxiphoid incisional hernia Material and Methods 57-year-old female presented with subxiphoid swelling post CABG in 2019. Her surgery was complicated with sternotomy wound infection with VAC dressing application and ARDS with prolonged intubation. She had 5x7 cm hernia defect that showed on the CT thorax along with sternal wound dehiscence. She underwent robotic repair of her hernia with phasix mesh and recovered well after surgery. Results The subxiphoid hernia is known for its repair complexities and high recurrence rate because the subxiphoid area is a complex structure consisting of boney structures, the rectus abdominis muscles, linea alba, and the diaphragm. The Da Vinci platform allows for accessing hard-to reach area with enhanced precision in dissection and superior dexterity compared to laparoscopy. The Robotic platform allows for manipulation of the camera to assess and operate on the abdominal wall with ease as compared to laparoscopy. Conclusions robotic repair of subxiphoid incisional hernia with mesh is safe and effective method of repair. There are no short-term or long- term side effects of the procedure with no recurrence at 6 months follow up.

scholarly journals Surgical Outcomes of Myelomeningocele Repair: a 20-Year Experience from a Single Center in a Middle-Income Country

2021 ◽  
Author(s):  
Sina Zoghi ◽  
Maryam Feili ◽  
Mohammad Amin Mosayebi ◽  
Mohammad Amin Afifi ◽  
Afrooz Feili ◽  
...  
Keyword(s):  
Surgical Management ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Wound Dehiscence ◽  
P Value ◽  
Fars Province ◽  
Middle Income ◽  
Middle Socioeconomic Status ◽  
Myelomeningocele Repair ◽  
Complications And Mortality

Abstract Objective Spina bifida primarily affects people of low and middle socioeconomic status. Herein, we describe the outcome of myelomeningocele surgical management in Iran and predictors of its postoperative complications and mortality. Methods This retrospective chart review studies the children who underwent surgical management for myelomeningocele in Shiraz, Fars province, Iran, from May 2001 to September 2020. To this end, we investigated mortality and 30-day complications and the factors that determined the operation's outcome. Results 256 patients were enrolled. The median age at the operation was roughly eight days (IQR: 7). The most common site of involvement of Myelomeningocele (MMC) was Lumbosacral (86%, n = 204). At the evaluation conducted prior to operation, CSF leaking was observed in 7% (n=16) of the patients. Postoperatively, 5.7% of the patients were expired in the 30 days following the operation (n = 14), while 24% needed readmission (n = 47). The most common complications leading to readmission included wound dehiscence (n = 10, 42%) and wound purulence (n = 6, 25%). No variable was significantly associated with postoperative complication except for the site of the lesion (p-value = 0.035) and the presence of the lipid content in the defect (p-value = 0.044). Conclusions Most patients born with MMC are referred for the neurosurgical evaluation following their birth; however, as results show there is much left to be desired compared with the 48h recommended by The Congress of Neurological Surgeons. Here, we concluded that presence of lipid compartment in the lesion and the site of the lesion are the two factor that were associated with the rate of mortality. However, further investigation into preoperative interventions and risk factors to mitigate risk of postoperational complications and mortality is highly encouraged. We highly advocate for the investigation and dissemination of the outcome of the conventional surgical management of MMC in financially restrained areas; because they can show the limitation these settings are confronted with (that are in a way unique to them and different from the resourceful settings) and provide a model for other similar areas with limited suitable care.

On-ward surgical management of wound dehiscence: report of a single neurosurgical center experience and comparison of safety and effectiveness with conventional treatment

2018 ◽  
Vol 43 (1) ◽  
pp. 131-140
Author(s):  
Alessandro Di Rienzo ◽  
Roberto Colasanti ◽  
Valentina Liverotti ◽  
Roberta Benigni ◽  
Riccardo Paracino ◽  
...  
Keyword(s):  
Surgical Management ◽  
Conventional Treatment ◽  
Wound Dehiscence

scholarly journals Topical negative pressure for the treatment of neonatal post-sternotomy wound dehiscence

2012 ◽  
Vol 94 (1) ◽  
pp. e33-e35 ◽  
Author(s):  
J Hardwicke ◽  
H Richards ◽  
J Jagadeesan ◽  
T Jones ◽  
R Lester
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Wound Dehiscence ◽  
Ion Concentration ◽  
Local Effects ◽  
Hydrogen Ion Concentration ◽  
Early Management ◽  
Topical Negative Pressure ◽  
Arterial Blood ◽  
Sternal Wound Dehiscence

The use of topical negative pressure (TNP) dressings for sternal wound dehiscence or mediastinitis in the neonatal population is rare. The majority of case reports have focused on wound healing as an endpoint and have not discussed the physiological advantage that TNP dressings may impart with regard to sternal stabilisation, improved respiratory function and early weaning from mechanical ventilation. We present a case of the use of TNP in neonatal post-sternotomy wound dehiscence and mediastinitis, from a UK perspective, with an emphasis on wound healing and physiological optimisation. As well as an improvement in sternal wound healing due to the local effects of the TNP system, serial arterial blood gas analysis revealed a significant improvement in systemic physiological parameters, including a reduction in pCO2 in the period (days 20–31) after application of TNP (p<0.0001) compared to the period before where simple occlusive dressings were applied. Hydrogen ion concentration also significantly reduced in this period (p=0.0058). The use of the TNP system in association with systemic antibiotics successfully treated the mediastinitis. A sealed, controlled wound environment also allowed ease of nursing and an expedited return to care by the parents. We would recommend the consideration of TNP dressings in similar cases of neonatal and paediatric sternal wound dehiscence. Not only do we observe the local effects of improved wound healing, the systemic effects of improved lung function are also valuable in the early management of such complex cases.

Sternal wound dehiscence after transverse thoracosternotomy for bilateral lung transplantation: Report of a case

Surgery Today ◽  
2008 ◽  
Vol 38 (10) ◽  
pp. 942-944
Author(s):  
Fengshi Chen ◽  
Akihiro Aoyama ◽  
Nobuyuki Kondo ◽  
Takuji Fujinaga ◽  
Tsuyoshi Shoji ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Wound Dehiscence ◽  
Bilateral Lung Transplantation ◽  
Bilateral Lung ◽  
Sternal Wound Dehiscence
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