Cases reported "Surgical Wound Dehiscence"

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11/169. Late traumatic wound dehiscence after phacoemulsification.

    Scars from scleral tunnel or clear corneal incisions for phacoemulsification should theoretically be stronger than the larger incisions of planned extracapsular cataract extraction. They should also be more resistant to blunt trauma. We present a case of scleral tunnel wound dehiscence and expulsion of a posterior chamber silicone intraocular lens after blunt trauma.
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keywords = wound
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12/169. Bacterial endophthalmitis following suture removal after penetrating keratoplasty.

    Of three cases of bacterial endophthalmitis occurring after removal of corneal sutures following penetrating keratoplasty, two were associated with wound dehiscence and one was not. Factors that may predispose to wound dehiscence and subsequent infection are: use of fine suture material, corticosteroids, and chronic topical antibiotics; early removal of corneal sutures; lack of adherence to strict asepsis prior to and after suture removal; and open suture tracts that may be kept open by incarceration of vitreous strands. Late corneal wound dehiscence may occur with subsequent development of endophthalmitis as long as three days after suture removal. The use of topical antibiotics before and after suture removal may decrease the potential for infection. In addition, early recognition of intraocular infection by the patient and the surgeon for immediate institution of antimicrobial and anti-inflammatory therapy may preserve useful vision.
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13/169. Neonatal wound dehiscence and the subsequent healing process: a case study.

    Many neonates require abdominal surgery for a variety of reasons, including necrotizing enterocolitis (NEC). Secondary complications of abdominal surgery include alterations in skin integrity and potential wound dehiscence. These alterations may actually worsen when treated with products "traditionally" used postoperatively. The author simultaneously utilized basic wound care products with currently recognized therapies in managing a 29-week premature infant who experienced dehiscence secondary to bowel repair. By utilizing the correct products and incorporating the principles of moist wound healing and occlusion, this Stage III/IV wound, measuring 12 cm x 3 cm, closed within 35 days of dehiscence. A team-oriented and coordinated approach proved that wounds can, and will, improve, even in this fragile population.
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ranking = 1.8
keywords = wound
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14/169. vacuum-assisted wound closure: a new approach to spinal wounds with exposed hardware.

    STUDY DESIGN: The use of vacuum-assisted therapy to close upper thoracic and thoracolumbar spinal wounds was studied retrospectively. Two patients whose wounds failed conservative management were successfully treated by negative pressure therapy. OBJECTIVES: The authors evaluated the efficacy of applying vacuum therapy on patients with exposed spinal hardware and summarized current knowledge about this treatment. SUMMARY OF BACKGROUND DATA: vacuum therapy was applied three times on two patients. methods: Success was defined as a stable, closed wound that required no future surgery and had no signs of chronic infection. RESULTS: Both patients' wounds were closed successfully and have received follow-up treatment for up to 10 months with no sign of recurrence. CONCLUSIONS: The cases illustrate the usefulness of vacuum-assisted therapy as an adjunct in closing complex back wounds with exposed spinal hardware. In the authors' experience, it helps establish a soft tissue envelope for wound healing and simplifies the need for future surgery.
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ranking = 2.8
keywords = wound
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15/169. Above the knee amputation wound which dehisced following surgery.

    This case study describes the wound care of Mrs A, a female patient whose above the knee amputation wound dehisced after surgery. The management of this wound was complex and challenging and required that many members of the multidisciplinary team to work together to achieve a satisfactory outcome.
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keywords = wound
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16/169. Late-onset traumatic laser in situ keratomileusis (LASIK) flap dehiscence.

    PURPOSE: To report a case of laser in situ keratomileusis (LASIK) flap dehiscence following focal trauma six months after uneventful refractive surgery. methods: Case report. A 37 year old man was seen one day after a tree branch snapped tangentially against his left cornea causing a dehiscence of his LASIK flap. RESULTS: The flap was repositioned after treating the exposed flap stroma with a 50:50 mixture of distilled water and balanced salt solution. The patient regained 20/20 uncorrected visual acuity. CONCLUSIONS: patients should be informed about the potential for traumatic flap dehiscence following LASIK surgery and advised to wear eye protection when appropriate. Due to minimal wound healing except at the edges of the flap, corneal flap dehiscence may occur months or years after uneventful LASIK.
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ranking = 0.2
keywords = wound
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17/169. Occult wound leak diagnosed by ultrasound biomicroscopy in patients with postoperative hypotony.

    PURPOSE: To describe the ability of high-frequency ultrasound biomicroscopy (UBM) to diagnose occult wound leaks as a cause for hypotony after cataract surgery. methods: Six patients with persistent hypotony after cataract surgery were sent for UBM examination. Slitlamp examination and gonioscopy of the 6 eyes had not revealed a cause for the hypotony. RESULTS: Ultrasound biomicroscopy showed subtle wound separation with shallow conjunctival elevation at the site of the cataract wound in the 6 patients. Two eyes had surgical repair of the subconjunctival wound leak, and the other 4 were treated medically. In the 2 eyes with surgically repaired wounds, the hypotony cleared after wound closure. Of the 4 medically treated eyes, hypotony resolved in 2 and 1 had a recurrence of hypotony. The other 2 eyes had fluctuating intraocular pressure for an extended period. CONCLUSIONS: Hypotony after cataract surgery occurred in 6 eyes due to subtle wound leaks difficult to detect by clinical observation. Ultrasound biomicroscopy can be a helpful aid to clinical examination in detecting these leaks.
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ranking = 2.2
keywords = wound
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18/169. Traumatic wound dehiscence following cataract surgery: a thing of the past?

    PURPOSE: This study compares the frequencies of traumatic wound dehiscence following extracapsular cataract extraction (ECCE) and following phacoemulsification through a self-sealing corneoscleral tunnel. methods: A retrospective review was performed of the surgical record at a British eye hospital from September 1986 to August 1993 and January 1996 to December 1998. Cases requiring surgical repair of wound dehiscence following cataract extraction were identified. The frequencies of traumatic wound dehiscence following ECCE and phacoemulsification were compared using a two by two contingency table (chi-square test). RESULTS: Twenty-one cases of traumatic wound dehiscence were identified following 5,600 ECCEs (0.4%). In 4,200 phacoemulsification procedures only one case of traumatic wound dehiscence was identified (0.02%) (p = 0.0006, OR 15.8, chi2 = 11.69). CONCLUSION: phacoemulsification through a self-sealing corneoscleral tunnel is associated with significantly less risk of traumatic wound dehiscence than is extracapsular cataract extraction. The case of wound rupture following phacoemulsification is discussed with reference to a mechanism for the injury.
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ranking = 2.2
keywords = wound
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19/169. Sternal dehiscence after cardiac surgery and ACE inhibitors [correction of ACE type 1 inhibition].

    We report two cases, which underwent surgery through Median sternotomy. They were on ACE inhibitors [corrected] pre-operatively. Both of these patients developed persistent dry cough post-operatively, which resulted in sternal wound dehiscence. They had no clinical or bacteriological evidence of sternal wound infection. Although one patient was overweight and had moderately impaired left ventricular function, there were no other associated risk factors. Both patients underwent rewiring of the sternum. Type II receptors inhibitor were introduced post-rewiring, which cured the persistent dry cough. Both the patients are enjoying a good quality of life at 2 year 6 months and 2 years post-rewiring of the sternum.
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ranking = 0.49318558206209
keywords = wound, wound infection
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20/169. rupture of a radial keratotomy incision after 11 years during clear corneal phacoemulsification.

    We report a case of rupture of a radial keratotomy (RK) incision that occurred during clear corneal phacoemulsification 11 years after the initial surgery. The RK was done in both eyes for correction of high myopia (>8.0 diopters). This was followed by 2 enhancement procedures at 6 month intervals. The patient presented with diminished vision in both eyes. The diagnosis was nuclear cataract in the right eye, and clear corneal phacoemulsification was done. The intraoperative and postoperative courses were uneventful. Nine months later, clear corneal temporal phacoemulsification was done in the left eye. During surgery, 1 of the radial incisions opened to one third its length. The wound was sutured, and the procedure was completed uneventfully. One month later, best corrected visual acuity was 20/20.
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ranking = 0.2
keywords = wound
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