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[1] [2] [3] The use of this technique in wound management started in the 1990s and this technique is often recommended for treatment of a range of wounds including dehisced surgical wounds, closed surgical wounds, open abdominal wounds, open fractures, pressure injuries or pressure ulcers, diabetic foot ulcers, venous insufficiency ulcers, some ...
In 1888, Dr. Henry O. Marcy first discussed using exploratory laparotomy as a means of diagnosing acute nontraumatic abdominal and pelvic problems at the 39th Annual Meeting of the American Medical Association, citing how improvements in safe surgical methods "so greatly increased the utility of the operation". [20]
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.
The area is subjected to a variety of loads approaching from abdominal contents, pressure from abdominal/diaphragm muscles, and genital organs, as well as respiratory actions. For the average, reproductive-age woman, the pelvis must withstand loads of 20 N in the supine position, 25-35 N in the standing position, and 90-130 N whilst coughing. [ 6 ]
Wound bed, wound edge and periwound skin should be examined before the initial treatment plan is devised. It should also be re-assessed at each visit or each dressing change. For wound bed, the following parameters are assessed: Tissue type; presence and percentage of non-viable tissue covering the wound bed; Level of exudate; Presence of infection
Postoperative wounds are those wounds acquired during surgical procedures. Postoperative wound healing occurs after surgery and normally follows distinct bodily reactions: the inflammatory response , the proliferation of cells and tissues that initiate healing , and the final remodeling .
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. [4]
He became America's leading authority on gunshot wounds [15] and was widely recognized for his skill as a surgeon. By the late 1950s, mandatory laparotomy had become the standard of care for managing patients with abdominal penetrating trauma. [16] A laparotomy is still the standard procedure for treating abdominal gunshot wounds today. [16]