Fascial Disruption

Question 0

Evisceration? Increased risk of?

Tx?

Answer 0

Instruction of all layers of incision with Intestinal contents penetrating through incision

Sepsis

1. Cover with sterile wet sponge
2. Immediately start antibiotics
3. Emergent surgery

Question 1

Typical presentation for fascial disruption? Mechanism?

Answer 1

Profuse and continuous serosanguineous drainage from the incision 5-14 days postsurgery

Because rectus fascia is interrupted, peritoneal fluid escapes through wound

Question 2

Fascial disruptions – treatment?

Answer 2

Emergent surgery followed by broad-spectrum antibiotic therapy

Question 3

Pt with fascial dehiscence are likely to have? (Risk factors)

Answer 3

Obesity, diabetes, cancer, vertical incision, coughing

Question 4

Wound dehiscence?

Answer 4

Separation of part of the surgical incision, but peritoneum intact

Question 5

Surgical site infection?

Answer 5

Infection related to procedure that occurs within 30 days

Question 6

Subcutaneous separation of incision leading to an infection – presents when? Signs? Treatment?

Answer 6

4-10 days post operatively

Red, tender, indurated decision

1. Reopen the wound and drain
2. broad-spectrum antibiotics
3. Wet-to-dry dressing

Question 7

Why is diabetes associated with an increased risk for fascial separation?

Answer 7

Poor wound healing due to Poor blood circulation

Question 8

Fascial disruption due to what suture problem? Tx?

Answer 8

Suture tearing through tissues

Immediate repair and broad-spectrum antibiotics