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Injuries in Children
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The cosmetic result for a wound closed with tissue adhesive is the same as for wound closure achieved with sutures, staples or adhesive strips. However, because of the weaker tensile strength of glues they can be used only on low-tensile, immobile wounds less than 3 cm in length. There is a slight increase in the incidence of wound dehiscence, but all other wound complications are the same.
Complications of open aortofemoral bypass
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Surgical wound dehiscence can be superficial or deep, and management is often dictated by the presence of concomitant infection and depth of involvement, particularly in regards to the underlying graft and vessels. The Szilagi classification is often used, with type I limited to skin necrosis, superficial wound dehiscence, and/or local infection. Type II includes deep wound dehiscence and fat necrosis, whereas Type III involves the underlying graft.
Wound infections and dehiscence
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
SSIs can vary in presentation and include anything from a small weeping wound to a dehisced laparotomy scar (‘burst abdomen’), which is a surgical emergency. Wound dehiscence is most commonly caused by infection. The second most common cause is a wound placed under too much tension. A wound under excessive tension due to poor surgical technique is vulnerable to dehiscence in the second week when the patient is beginning to mobilise and the scarring is at its weakest.
Upper blepharoplasty: advanced techniques and adjunctive procedures
Published in Expert Review of Ophthalmology, 2023
Parya Abdolalizadeh, Mohsen Bahmani Kashkouli, Vahid Khamesi, Nasser Karimi, Hossein Ghahvehchian, Leila Ghiasian
An ideal wound closure relies on approximation with minimal tension while keeping the edges relatively everted. Suture failure results in wound dehiscence. The incidence of lateral wound dehiscence with subsequent scarring (Figure 2), has been reported to be nearly 2% [7,71,72]. Risk factors for wound dehiscence can be divided into three categories. Patient factors are older age, male gender, and underlying systemic comorbidities such as diabetes, anemia, and malignancy [7 [71–73],]. A wider lateral skin excision (e.g. intended to address the lateral hooding) may also lead to wound dehiscence after skin suture removal [7]. One to three absorbable buried tension relieving sutures before lateral skin closure may not only prevent wound dehiscence and scar (Figure 2) but also provides a tissue barrier to lacrimal gland prolapse and prevent its recurrence [5,7]. There is no difference in wound dehiscence between various incision devices including carbon dioxide laser, radiowaves, scalpel, and radiofrequency [6,74–76]. However, fast-absorbing sutures are associated with higher wound dehiscence after UB [71]. Postoperative infection and extensive hematoma could lead to wound dehiscence. Farhangi et al. [77] showed that superficial adhesive breathable tapes can be used as an adjunct, postoperatively which result in improvement of wound healing, reduction of inflammation, and less wound dehiscence.
Randomized Single-Center Study of Effectiveness and Safety of a Resorbable Lysine-Based Urethane Adhesive for a Drain-Free Closure of the Abdominal Donor Site in a DIEP Flap Breast Reconstruction Procedure
Published in Journal of Investigative Surgery, 2022
Sonia Fertsch, Michal Michalak, Christoph Andree, Beatrix Munder, Mazen Hagouan, Tino Schulz, Peter Stambera, Katinka Steammler, Lukas Grueter, Julia Kornetka, Andreas Wolter
The patients were followed up until seroma was resolved and in general for 8 consecutive weeks. Most seroma resolved by week 4 and 2 patients had a seroma until week 5. There was no postoperative bleeding in neither group (Table 4). A wound infection was seen in two patients (7%) from the study group and in two patients (7%) from the control group. The infection was in form of abdominal redness either along the abdominal scar or the umbilicus and was successfully treated with antibiotics. Wound dehiscence occurred in two patients (7%) from the study group and 1 patient (3%) in the control group. All cases of dehiscence were around the umbilicus. In one case a suture stitch was applied to readapt the umbilicus to the skin. In the other two cases the wound healed by secondary intention.
A technique for eyelid margin repair without use of marginal sutures
Published in Orbit, 2021
C. Pham, N. G. Valikodath, D. Reine, P. Setabutr
Due to the absence of lid margin sutures, potential disadvantages to the use of our technique are wound dehiscence and the inability to sufficiently evert wound edges which may result in an additional procedure or affect the overall cosmesis and patient satisfaction. We observed no incidents of wound dehiscence – in comparison, Devoto et al. reported dehiscence in 2/300 of their patients. We report post-operative notching in 7.7% of our patients which is similar to other published results. Burroughs et al. reported lid notching in 5.5%, Custer and Vick found 3 incidents of lid notching or peaking in 3 of 31 eyelids repaired (9.6%), while Tyers et al. observed 1 incident of persistent lid notching in their prospective group using a buried margin knot (1/24; 4.2%).3,6,8 We postulate that meticulous approximation and use of polyglactin suture (which has tensile strength similar to silk)11 enable precise and strong closure that allows for similar outcomes to previously reported techniques without the risk for margin-suture-related keratopathy and need for suture removal or trimming (Figure 2).