Gastrointestinal System Disorders Q 49 - Gyan Darpan : Learning Portal
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Saturday, 16 April 2022

Gastrointestinal System Disorders Q 49

Your patient recently had abdominal surgery and tells you that he feels a popping sensation in his incision during a coughing spell, followed by severe pain. You anticipate an evisceration. Which supplies should you take to his room?
    A. A suture kit.
    B. Sterile water and a suture kit.
    C. Sterile water and sterile dressings.
    D. Sterile saline solution and sterile dressings.

Correct Answer: D. Sterile saline solution and sterile dressings.

Saline solution is isotonic, or close to body fluids in content, and is used along with sterile dressings to cover an eviscerated wound and keep it moist. If the wound shows signs of evisceration, the wound can be covered with a sterile saline dressing until the herniating organs can be reduced back into the abdomen.

Option A: A suture kit would be needed later during closure of the wound. Dehiscence is a partial or total separation of previously approximated wound edges, due to a failure of proper wound healing. This scenario typically occurs 5 to 8 days following surgery when healing is still in the early stages. The causes of dehiscence are similar to the causes of poor wound healing and include ischemia, infection, increased abdominal pressure, diabetes, malnutrition, smoking, and obesity
Option B: When dehiscence is identified, it is crucial to determine the extent of wound failure. Superficial dehiscence can be managed with abdominal binders to reduce strain on the wound and prevent further dehiscence. The existing wound failure may be allowed to heal by secondary intention or can close secondarily.
Option C: Deep dehiscence of the underlying fascia is a surgical emergency and must be closed in the operating room, as this can lead to evisceration. Secondary closure is preferred to healing by secondary intention in patients with superficial dehiscence. Patients who underwent secondary closure experience a faster healing time and fewer postoperative visits than the healing by secondary intention group.

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