Post-thoracotomy wound separation (DEHISCENCE): A disturbing complication

Abstract

OBJECTIVES:We described the treatment of dehiscence of thoracotomy incisions in patients who underwent thoracic surgery in the present study.METHODS:Twenty-four patients with either partial or complete dehiscence of their thoracotomy incisions were included in the study from 2005 to 2010. The patients were evaluated regarding their age, sex, indication for thoracotomy, and surgical approaches. We also described our method of re-closure.RESULTS:The male/female ratio was 17/7. The youngest and oldest patients were 15 and 75 years old, respectively, and the mean age was 43 years. Among the indications for thoracotomy, empyema was the most common reason (determined in eight [33%] patients), followed by vertebral surgery (determined in six [25%] patients). Bacterial growth was detected in the wound site cultures from 13 (54%) patients. For the patients with dehiscence of their thoracotomy incisions, an en block approximation technique with debridement was performed under general or local anesthesia in 16 (66%) and eight (33%) of the cases, respectively. Three patients exhibited an open thorax with dehiscence of the thoracotomy incision. Thoracoplasty was required in two patients. Using this method, successful closure was obtained in 91.7% (n = 22) of the patients with dehiscence of their thoracotomy incisions.CONCLUSION:Dehiscence of the thoracotomy incision is an important complication that causes concern in patients and their thoracic surgeons and strongly affects the success of the surgery. An en block approximation technique with significant debridement that enables removal of the necrotic tissues from the wound site can successfully be applied to patients with dehiscence of their thoracotomy incisions.

Faktor Prediktor Dehisensi pada Neonatus dengan Pembedahan Abdominal

“…Besar sampel dihitung sesuai jenis masalah analisis komparatif kategorikal tidak berpasangan, dengan kesalahan tipe I ditetapkan 5%, hipotesis satu arah (Zα=1,65) dan kesalahan tipe II ditetapkan 20% (Zβ=0,84 Dehisensi merupakan komplikasi bedah sehingga proses penyembuhan luka mengalami kegagalan dan sepanjang luka insisi operasi menjadi terbuka. 7 Kami mendapatkan angka kejadian dehisensi yang terjadi pada neonatus dengan pembedahan abdominal selama 6 tahun terakhir adalah 24,5%. Angka tersebut jauh lebih tinggi dari penelitian sebelumnya karena subjek adalah neonatus yang memang diketahui menjadi faktor risiko dehisensi.…”