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Medical Education Division |
Operational Medicine 2001
Emergency War Surgery
Second United States Revision of The Emergency War Surgery NATO
Handbook
United States Department of Defense
Emergency War Surgery
Second United States Revision of The Emergency War Surgery NATO Handbook
United States Department of Defense
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Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXX: Reoperative Abdominal Surgery Specific Reasons for Reoperations: DehiscenceUnited States Department of Defense In addition to wound infection, two factors contribute to dehiscence: the failure to place retention sutures in war wounds, and the air evacuation of patients with postoperative ileus. The lowest incidence of dehiscence is achieved when the abdomen is closed with retention sutures, 2-3 cm apart, through all layers, in combination with closure of individual layers. Of the 626 casualties with abdominal wounds seen at Clark AFB, there were 26 with dehiscence (4.1%). Retention sutures had not been used in any of the 26 cases. Ileus is a factor in dehiscence because of the pressure exerted by distended bowel on the abdominal wound. Bowel gas expands by 15-30% of sea level volume at the usual cabin pressure of evacuation aircraft. The avoidance, therefore, of evacuation when ileus exists is desirable. The use of reliable nasogastric decompression minimizes this problem.
Approved for public release; Distribution is unlimited. The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. Operational Medicine 2001 Health Care in Military Settings
This web version is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. |