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An exploratory laparotomy is a general surgical operation where the abdomen is opened and the abdominal organs are examined for injury or disease. It is the standard of care in various blunt and penetrating trauma situations in which there may be life-threatening internal injuries.
The wound usually appears red and can be accompanied by drainage. Clinicians delay re-opening the wound unless it is necessary due to the potential of other complications. If the surgical wound worsens, or if a rupture of the digestive system is suspected the decision may be to investigate the source of the drainage or infection. [2] [3]
There are four main complications. The first is development of an intra-abdominal abscess. This has been reported as high as 83%. [20] [21] Next is the development of an entero-atmospheric fistula, which ranges from 2 to 25%. [5] [24] The third is abdominal compartment syndrome that has been reported anywhere from 10 to 40% of the time.
Depending on incision placement, laparotomy may give access to any abdominal organ or space, and is the first step in any major diagnostic or therapeutic surgical procedure of these organs, which include: [citation needed] the digestive tract (the stomach, duodenum, jejunum, ileum and colon) the liver, pancreas, gallbladder, and spleen; the bladder
The type of wound (incision, laceration, puncture, etc.) has a major effect on the way a wound is managed, as does the area of the body affected and presence of any foreign objects in the wound. A serious wound or any complication may require a call to emergency medical services. Any wound requires being disinfected after it stops bleeding.
Wound assessment is a component of wound management.As far as may be practical, the assessment is to be accomplished before prescribing any treatment plan. The objective is to collect information about the patient and about the wound, that may be relevant to planning and implementing the treatment.
The purpose of a drain is to prevent fluid (blood or other) build-up in a closed ("dead") space, [2] which may cause either disruption of the wound and the healing process or become an infected abscess, with either scenario possibly requiring a formal drainage/repair procedure (and possibly another trip to the operating room).
The wound can be allowed to close by secondary intention. Alternatively, if the infection is cleared and healthy granulation tissue is evident at the base of the wound, the edges of the incision may be reapproximated, such as by using butterfly stitches , staples or sutures .