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Stoma Management in the Acute Abdomen
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
James W. Fleshman, Walter R. Peters
Evisceration is a rare condition. It is therefore impossible to ascertain causative factors, but evisceration is more likely to occur in the face of increased intra-abdominal pressure caused by a bowel obstruction or severe coughing with COPD. It is also more likely to occur in patients with poor healing at the mucocutaneous border of the stoma. Malnourished patients, the elderly, patients on chronic corticosteroids and those with reduced intraabdominal adhesions, as might be seen after laparoscopic surgery or placement of an adhesive barrier are potentially at risk. In one reported case, evisceration was thought to be due to chronic prolapse of a transverse colostomy that led to necrosis of the colonic wall.10
Complications of Abdominal Wall Surgery and Hernia Repair
Published in Stephen M. Cohn, Matthew O. Dolich, Complications in Surgery and Trauma, 2014
Ethan A. Taub, Jane Kayle Lee, James C. Doherty
Acute wound failure includes two distinct entities: dehiscence and evisceration. Dehiscence is defined as separation of the wound edges. Evisceration occurs when intra-abdominal viscera exit the wound. Dehiscence can occur without evisceration; however, in rare cases, the first sign of dehiscence is acute evisceration. The average time occurrence for wound failure is on the seventh postoperative day.
Reconstruction of the Body
Published in Julian L Burton, Guy Rutty, The Hospital Autopsy, 2010
At the end of the evisceration, the body cavity will usually have residual body fluids, tissues and even bowel contents within it. All of these must be removed to prevent leakage. In the UK, with the introduction of legislation by the Human Tissue Authority (HTA), ‘tissue’ includes blood products – so residual blood and cellular material should remain with the body. This has created a dilemma for the technologist delegated to the reconstruction, as blood-stained fluid such as ascites and pleural fluid have in the past been removed and disposed of. Clarification was sought from the HTA on this specific subject. The HTA stated that ‘residual tissue is any tissue taken for a specific purpose’. As this residual fluid is not for a specific purpose, it can be disposed of as waste products; however, the body should be as complete as possible.
Demography, Clinical Settings and Outcomes in Evisceration with Implant: An Electronic Medical Records Driven Analytics of 2071 Cases
Published in Seminars in Ophthalmology, 2023
Tarjani Vivek Dave, Anthony Vipin Das, Samir Mohapatra, Oshin Bansal, Anasua Ganguly
The data of 1,345,480 patients were retrieved from the electronic medical record database and segregated into a single excel sheet. A total of 2071 patients underwent evisceration during the study period and were included in the study. The columns with data on demographics, clinical presentation and ocular diagnosis were exported for analysis. The excel sheet with the required data was then used for analysis using the appropriate statistical software. The geographic categorization of the districts of India was performed in accordance with the National Sample Survey Organization (NSSO), which defines ‘rural’ as an area with a population density of up to 400 per square kilometer.7 The Constitution (seventy-fourth Amendment) Act, 1992 defines a metropolitan area in India as, an area having a population of one million or more, comprised in one or more districts and consisting of two or more municipalities or panchayats or other contiguous areas, specified by the Governor by public notification to be a metropolitan area. The remaining districts were classified as urban.8
Amplitude of movements with conical or spherical implants in anophthalmic socket
Published in Orbit, 2022
Carolina Pereira Bigheti, Oscar Peitl, Gabriel de Almeida Ferreira, Silvana Artioli Schellini
Evisceration was performed by two main surgeons following standardized surgical technique. After adequate local or general anesthesia, the conjunctiva was opened in 360° around the cornea. The anterior chamber was penetrated using blade 11 at 12 o’clock superior corneal limbus. The cornea was then removed, and the intra-ocular content was meticulously removed. Then, a circular aperture was performed around the optic nerve to facilitate the placement of the implant. After the implant was inserted, the sclera in the anterior portion of the socket was closed with interrupted non-absorbable 6–0 braided sutures (Mersilene 6–0, Ethicon, Johnson & Johnson, São Paulo, Brazil). Tenon’s capsule was closed with non-interrupted absorbable 6–0 suture and the conjunctiva was then closed with interrupted same absorbable 6–0 suture (Vicryl 6–0, Ethicon, Johnson & Johnson, São Paulo, Brazil). At the end of the surgical procedure, the patient received a subconjunctival injection of gentamicin (80 mg/2 mL) (Mantecorp, São Paulo, Brazil) and dexamethasone (2 mg/mL) (Ache, São Paulo, Brazil). A temporary ocular conformer was placed, and a pressure patch was applied for 12 hours. The conformer was maintained for 4 weeks and then the patient received an EOP.
Eye Socket Regeneration and Reconstruction
Published in Current Eye Research, 2020
M. Borrelli, G. Geerling, K. Spaniol, J. Witt
More recently, human amniotic membrane (AM) – the innermost layer of the placenta – has been introduced for conjunctival reconstruction. Since then it has been successfully used as a graft in the treatment of mild chemical injuries21, symblepharon (OCP)22,23 and SJS.24 AM can be helpful in more extensive ocular socket reconstruction such as after large-surface tumour excision (Figure 2) as it contains several cytokines and growth factors, is able to promote cell growth and inhibits inflammation and fibrosis.26–28 In cases of mild to moderate socket contractions in anophthalmic contracted sockets, Bajaj et al. have shown that AM grafting alone leads to acceptable results with no differences in fornix depth, socket volume or motility of a prosthetic eye compared to mucous membrane grafting.29 The augmentation with topical mitomycin C (MMC) application during reconstruction surgery for contracted socket improves the outcome of AM grafting.30 Mandour et al. placed surgical sponges soaked in 0.2 mg/ml MMC under the conjunctival flaps for 5 min and reported a significant deeper fornix in MMC-treated eyes and that 75% of these patients could maintain the prosthesis after 12 months while only 35% of the patients in the non-augmented group could maintain the prosthetic shell. Evisceration was performed on average 42 to 45 months prior to surgery due to microophthalmus, chemical injury, glaucoma, atrophic bulbi, endophthalmitis or traumatic or pathological rupture of the globe.30