The Reclosure of Postoperative Incisional Abscesses Based on Bacterial Quantification of the Wound
| Autor: | John P. Heggers, Richard C. Shaw, Martin C. Robson |
|---|---|
| Rok vydání: | 1970 |
| Předmět: |
medicine.medical_specialty
Time Factors medicine.medical_treatment media_common.quotation_subject Incision and drainage medicine Humans Surgical Wound Infection Abscess media_common Wound Healing Debridement Bacteria integumentary system business.industry Convalescence Time optimal medicine.disease Catheter irrigations Secondary intention Surgery Hospitalization Anesthesia Drainage business Wound healing Research Article |
| Zdroj: | Annals of Surgery. 171:279-282 |
| ISSN: | 0003-4932 |
| Popis: | THE principle of treatment of fresh contaminated wounds by wide debridement and delayed closure is accepted in both military and civilian practice.3 8 The treatment of abscesses in postoperative wounds in similar fashion is not universally accepted. There is a reluctance among surgeons to open widely a wound which has been meticulously closed. Howe pointed out that massive wound infections are frequently treated by small openings, inadequate drainage, and catheter irrigations which often results in prolonged convalescence, tissue destruction, and eventual herniation.6 Robson and Heggers demonstrated that infections result from contamination by an imbalance in the equilibrium between the bacteria and host resistance.9 One difference between a septic incision and a contaminated wound is the number of viable bacteria present. Howe stated that once a postoperative wound infection has been converted to a "clean" wound it can be treated as any other wound and surgically closed.6 We have shown that if 100,000 or fewer bacteria are present per gram of tissue that a wound can be considered "clean" and closed with a 94 per cent chance of success." If following adequate drainage of an incisional abscess the bacterial count could be decreased to 105 organisms or less per gram of tissue, successful reclosure of the wound would be similarly successful. The purpose of this study is to determine the feasibility of bacterial quantification for determining optimal time for reclosure of incisional abscesses and to compare the hospital courses of patients so treated with the courses of those managed by conventional incision and drainage followed by healing by secondary intention. |
| Databáze: | OpenAIRE |
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