Cases reported "Surgical Wound Dehiscence"

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11/46. Neurosurgical reconstruction with acellular cadaveric dermal matrix.

    Acellular cadaveric dermal matrix (ACDM) is processed from human cadaver skin (AlloDerm; life Cell Corp., Branchburg, NJ). It does not require an immediate blood supply but can transmit essential interstitial fluids for nourishment of overlying tissues. A number of neurosurgical reconstructions have required the use of tissue that fills these specifications. The material has been used most recently for reconstruction of dura during craniotomies when primary closure is not possible or harvesting from an autologous site is not available. Because ACDM is harvested from nonneurologic cadaveric tissues and because the cellular and antigenic elements have been removed from the matrix, prion diseases are not a transmission risk. We present 6 examples of previously unreported uses of ACDM for successful repair of meningomyelocele, cauda equina, encephalocele, cerebrospinal fluid fistula, and neuroma. We propose the use of ACDM as a valuable tool in neurosurgical reconstruction.
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ranking = 1
keywords = fistula
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12/46. Massive pharyngocutaneous fistulae: salvage with two-layer flap closure.

    Massive pharyngocutaneous fistulae may be arbitrarily defined as those involving two-thirds or more of the circumference of the pharyngeal wall. Three such patients are presented, all after failed radiotherapy and surgery. The principles of management consist of salivary diversion, complete debridement, nutritional support, prophylactic antibiotics, and two-layer, well-vascularized overlapping closure. We currently recommend a radial forearm flap used in conjunction with a pectoralis muscle (or musculocutaneous) flap for rapid rehabilitation of these patients, particularly in the presence of obesity or an irradiated bed.
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ranking = 5
keywords = fistula
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13/46. Bogota bag in the treatment of abdominal wound dehiscence.

    A patient who underwent emergency laparotomy for rectal prolapse developed repeated abdominal wound dehiscence and subsequently an enteric fistula. The management of abdominal wound dehiscence is discussed, specifically with regards to the Bogota bag. Use of Bogota bag has been reported worldwide but this may be the first report here.
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ranking = 1
keywords = fistula
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14/46. Two successful cases in the treatment of post-operative bronchial stump fistulae.

    We report on two successful cases of managing lung resections that had been complicated by bronchial stump fistulae. In the first case, an endobronchial blocker tube was used to intubate the patient, in order to control inflammation in the event of aspiration pneumonia. This treatment improved the general condition, so we were able to perform a second operation to close the fistula safely. This attachment is very useful in serious cases, allowing intervention before a second operation. In the second case, a bronchial fistula recurred following a second operation, which then healed without surgical treatment. A minimal fistula may heal spontaneously when it is wrapped with an appropriate, vascularized, pedicle flap in advance, and adequate drainage is provided.
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ranking = 8
keywords = fistula
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15/46. Extraperitoneal bladder leakage after provision of topical negative therapy: a case report.

    Following surgical excision of a prevesical haematoma, topical negative pressure was used to promote wound closure. The development of a vesicocutaneous fistula at the incision site may have been an indirect complication of the therapy.
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ranking = 1
keywords = fistula
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16/46. Bronchial myoplasty with the use of latissimus dorsi muscle--a case study.

    Dehiscence of the bronchial stump as well as the tracheo-bronchial-pleural fistula is a rare but life-threatening complication of pulmonary resections. Absence of the immediately accessible well vascularized soft tissues makes successful direct resuture of the bronchial stump or local closure of the defect problematic, particularly in the infected terrain. The authors describe a case study of successful closure of the tracheo-bronchial defect with the use of pediculated latissimus dorsi muscle in a cachectic 63-year-old patient after a right-side pneumonectomy.
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ranking = 1
keywords = fistula
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17/46. The "Fistula VAC," a technique for management of enterocutaneous fistulae arising within the open abdomen: report of 5 cases.

    BACKGROUND: Management of intestinal fistulae in open abdominal wounds remains a significant clinical challenge for those caring for patients surviving damage control abdominal operations. Breaking the cycle of tissue inflammation, infection, and sepsis, resulting from leakage of enteric contents, should be a major goal in the approach to these complex patients. We describe a technique utilizing vacuum assisted closure (VAC) which achieves control of enteric flow from fistulae in open abdominal wounds. methods: The fistula-VAC is fashioned from standard sponge supplies, negative pressure pumps, and ostomy appliances. The fistula-VAC was changed every three days prior to split thickness skin grafting, and every five days following grafting. RESULTS: Five patients underwent application of the fistula-VAC. All patients had complete diversion of enteric contents. This enteric diversion allowed for successful skin grafting in all patients. CONCLUSION: Application of the fistula-VAC should be considered a useful option in treating patients with intestinal fistulae in open abdominal wounds.
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ranking = 11
keywords = fistula
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18/46. Colocutaneous fistula management in a dehisced wound: a case study.

    A fistula is an abnormal opening between two or more organs or structures. Wound drainage containment is a key component of nonsurgical fistula management and may include pouches, skin barriers, transparent dressings, troughing procedures, saddle bagging, bridging, and condom and suction catheters used in combination with complex or routine pouching. Following extensive abdominal surgery, the wound of a 50-year-old woman dehisced and a colocutaneous fistula formed inside the wound. The wound containing the fistula, which was draining liquid stool, was too large for existing commercial pouching systems. When initial management efforts, including negative pressure wound therapy, failed to achieve containment goals, clinicians adapted the negative pressure wound therapy dressing to surround the fistula, which helped facilitate therapy while providing a platform for an ostomy appliance to contain the fistula drainage. The system was changed every 2 days until discharge. The wound and fistula management combination improved patient comfort and mobility, facilitated healing, and reduced patient dietary restrictions.
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ranking = 11
keywords = fistula
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19/46. The Convatec Wound Manager: a new stoma appliance.

    Very occasionally, the surgeon must deal with a complicated abdominal wound which drains large volumes of fluid. One such situation arises when a postoperative enteric fistula occurs in association with a partial or complete dehiscence of a laparotomy wound. Another example occurs when the abdominal cavity is left open in the management of severe intra-abdominal sepsis. Both result in large abdominal wounds that are not satisfactorily contained by conventional dressings. Frequent changes of dressing are required and considerable skin excoriation and damage may occur. In addition, quantification of fluid output from a fistula may be grossly inaccurate. We wish to report the use of a new stoma appliance, the Convatec Wound Manager (Squibb Surgicare) which facilitates the management of these wounds. The case described illustrates many of the advantages of the appliance.
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ranking = 2
keywords = fistula
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20/46. Surgical removal of cyanoacrylate adhesive after accidental instillation in the anterior chamber.

    Cyanoacrylate adhesives are frequently used to seal small corneal perforations. Their use has been limited, however, because of concern over their toxic effect on ocular structures. We describe a post-keratoplasty patient with a wound dehiscence that a surgeon had attempted to seal with cyanoacrylate glue. The glue was accidentally injected into the anterior chamber. After surgical reconstruction of the eye, however, no permanent ocular damage was observed.
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ranking = 0.017115398541997
keywords = dental
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