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Rashid, Muhammad Harun Ar, Liton Kumer Shaha, Sanjana Sharmin Shashi, and Imtiaz Faruk. "Risk Factors of Burst Abdomen in Emergency Laparotomy." Bangladesh Medical Journal 46, no. 2 (2019): 38–42. http://dx.doi.org/10.3329/bmj.v46i2.40217.
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Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study was carried out to find out various risk factors of burst abdomen following emergency laparotomy, to find out the high risk group of patients for burst abdomen, to determine the predictors of burst abdomen, to prevent the rate of burst abdomen & find out morbidity and mortality of burst abdomen. This cross sectional study was done among 100 cases of burst abdomen occurring in Sir Salimullah Medical College & Mitford Hospital, Dhaka and Dhaka Medical college,Dhaka during the period of July,2011 to December,2011. The patients were admitted for various surgical problems and underwent emergency laparotomy. Burst abdomen was taken into account. Another group of 100 patients who undergone emergency laparotomy but did not develop burst abdomen were also taken into account to make a comparison with the burst group. Patients who undergone elective laparotomy,paediatric age group,patients undergone exploration through mini laparotomy or transverse incision,patients with pregnancy were excluded from the study populations.Patients were assessed by history taking, examination and appropriate investigation before surgery and observed post operatively for any complication. The results were prepared on 100 patients underwent emergency laparotomy in SSMCMH & DMCH. Burst abdomen following emergency laparotomy results from multifactorial causes. The main outcome measure found significant as the risk factors of burst abdomen in this study were peritonitis (95%),anaemia (26%),malnutrition (18%), in the preoperative period; inadequate peritoneal toileting and faulty surgical techniques in the per operative period; and wound infection (62%), postoperative cough (28%), abdominal distension (22%). The result also shows that the rate of burst abdomen is still very high in SSMCMH & DMCH and most of them occur in operations done by trainee surgeons (86%) and in those patients who has 3 or more of the risk factors (44%). We hope this study will arouse awareness and concern about this problem, so that more active steps will be taken for its prevention by identifying the high risk groups. This will certainly reduce the incidence of burst abdomen.
 Bangladesh Med J. 2017 May; 46 (2): 38-42
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Pratama, Rafika Surya Putra, and Catur Widayat. "BURST ABDOMEN PASCA TINDAKAN LAPAROTOMI AKIBAT HIPOALBUMINEMIA PADA PASIEN USIA LANJUT: LAPORAN KASUS." Jurnal Medika Malahayati 8, no. 1 (2024): 114–18. http://dx.doi.org/10.33024/jmm.v8i1.12702.
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Abstrak: Judul Burst abdomen Pasca Tindakan Laparotomi Akibat Hipoalbuminemia Pada Pasien Usia Lanjut: Laporan Kasus. Burst abdomen merupakan keadaan gagalnya mekanisme penyembuhan luka (wound healing) insisi bedah yang mengakibatkan kerusakan pada lokasi sayatan operasi. Berbagai faktor risiko yang menyebabkan terjadinya burst abdomen antara lain iskemia, infeksi intra-abdomen, malnutrisi seperti hipoalbuminemia, anemia, usia lanjut, penyakit sistemik (uremia, diabetes melitus). Laporan kasus: seorang pasien Tn.T usia 73 tahun dengan burst abdomen dimana sebagian besar usus keluar dari rongga perut akibat dari dehisensi luka perut (abdominal wound dehiscence). Status lokalis pasien terdapat burst abdomen pasca operasi dengan panjang 15 cm pada regio umbilical serta terdapat eviserasi usus, sebagian besar usus keluar dari abdomen. Pemeriksaan penunjang laboratorium didapatkan kadar albumin: 2.4 g/dL. Hasil laboratorium menunjukkan kadar albumin darah yang sangat rendah. Pasien disiapkan untuk operasi darurat repair burst abdomen kemudian dilakukan transfusi albumin hingga mencapai nilai normal. Perkembangan luka bekas operasi perlahan pulih. Kesimpulan: Kejadian burst abdomen pada kasus pasien ini disebabkan oleh kondisi hipoalbuminemia. Faktor risiko dan etiologi lain yang menyertai meliputi: 1. Riwayat merokok, 2. Usia lanjut (geriatri), 3. Kurangnya pengetahuan pasien dan keluarga mengenai pentingnya asupan nutrisi terutama protein untuk proses penyembuhan luka.
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Jaiswal, N. K., and Sandeep Shekhar. "Study of burst abdomen: it’s causes and management." International Surgery Journal 5, no. 3 (2018): 1035. http://dx.doi.org/10.18203/2349-2902.isj20180826.
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Background: Burst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Burst abdomen is defined as post-operative separation of abdominal musculo-aponeurotic layers. The study aims to find etiological factors of burst abdomen in hospitalised patients ,evaluate current management methods and to compare conservative and operative approach with respect to complication and outcomes.Methods: All cases presenting with abdominal wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed , type of disease involved and management methods and their outcome. A total of 82 cases were included in this prospective study. Data was analysed using appropriate software.Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5th decade. Patients presenting with peritonitis secondary to gastro-duodenal perforation are more prone to burst abdomen.Conclusions: Burst abdomen is a serious sequel of impaired wound healing. Presence of anaemia, hypoproteinemia favours high incidence of burst abdomen. Delayed suturing, of burst abdomen has a lower frequency of complications . Adherence to proper technique and sincere efforts to minimize the impact of the predisposing factors play a much larger role in both treatment and prevention of this condition.
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Abbasi, Muhammad Sheraz, Imran Ashraf, Asad Noor, Sajid Zaman, Abaidullah Shaukat, and Bilal Sikandar Nagra. "Frequency of Burst Abdomen and Associated Risk Factors After Emergency Laparotomy in A Tertiary Care Hospital from Rawalpindi." Pakistan Armed Forces Medical Journal 75, no. 2 (2025): 409–12. https://doi.org/10.51253/pafmj.v75i2.11868.
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Objective: To assess the frequency of burst abdomen and associated risk factors after in patients undergoing laparotomy. Study Design: Prospective longitudinal study Place and Duration of Study: Combined Military Hospital Rawalpindi, Pakistan from Jan to Jun 2023 Methodology: One hundred and sixteen patients meeting our inclusion criteria who underwent emergency laparotomy were included in the study. Convenience sampling was performed for patient selection. The primary outcome was development of burst abdomen. Results: Of 116 patients, 75(64.7%) were male and 41(35.5%) were female, with a mean age of 41.11±15.13 years. The major primary diagnosis for which patients underwent laparotomy were peritonitis, intestinal obstruction and blunt trauma. Only 12(10.34%) patients developed burst abdomen. The major risk factors associated with burst abdomen (p< 0.05) were age, history of smoking, anemia, obesity, diabetes mellitus, malnutrition, post-operative ileus, wound infection, wound leakage, post-operative cough and vomiting. Obesity, smoking and vomiting were not significantly associated with development of burst abdomen (p> 0.05). Conclusion: We found that abdominal wound dehiscence, or burst abdomen, occurred in 10.34% patients who underwent emergency laparotomy at our set-up. The associated risk factors included wound infections, anastomotic leaks, and the presence of coexisting conditions like peritonitis, diabetes, anemia, malnutrition and advanced age.
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Islam, Dr Md Nazrul, Dr Rahat Anwer Choudhury, Dr Partho Sarkar, Dr Md Shabbir Hossain, and Dr Md Mamun Molla. "Prevention of Burst Abdomen by Interrupted Midline Fascial Closure in Emergency Laparotomy." IOSR Journal of Dental and Medical Sciences 23, no. 12 (2024): 66–71. https://doi.org/10.9790/0853-2312036671.
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Background: Burst abdomen represents one of the most frustrating and difficult postoperative complication that concerns every abdominal surgeon. It occurs because of various predisposing factors which can be prevented to some extend by having knowledge regarding them. Despite many years of experience, the optimal technique of emergency laparotomy closure remains more or less controversial. The varieties of surgical excess as well as the varieties of abdominal closure techniques are the main difficulties in the proper standardization of this procedure. Aims and Objectives: The aim of the study was to find out the technique of rectus sheath closure in patients undergoing emergency laparotomy that can reduce the burden of complications in post-operative period. Materials and methods: A total of 260 patients of acute abdominal condition who underwent laparotomy were randomized into two groups of 130 patients in each group. Results: Total 19(7.30%) of 260 patients developed burst abdomen in the post- operative period. Twelve 12(9.23%) in continuous arms and seven 7(5.34%) patients in interrupted arms developed burst abdomen. Burst abdomen occurring mostly 40-60 years of age group with a male to female ratio 1.48:1. Predictor Variables: Cough, anemia, malnutrition, DM, intraperitoneal Sepsis, wound infection, uremia and abdominal distension were the important predisposing factors for the incidence of burst abdomen. Conclusion: Interrupted suturing was associated with significantly reduced the burst abdomen when comparing with continuous closure.
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Parekh Chetan Sharma, Brijesh. "A Study of Burst Abdomen: It's Causes and Management." International Journal of Science and Research (IJSR) 12, no. 1 (2023): 430–33. http://dx.doi.org/10.21275/mr23110175136.
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Vardhini, K. Viveka, and D. Kishan. "Incidence and risk factors influencing morbidity and mortality in cases of burst abdomen after emergency and elective midline laparotomies." International Surgery Journal 5, no. 11 (2018): 3471. http://dx.doi.org/10.18203/2349-2902.isj20184611.
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Background: Burst abdomen is a serious postoperative complication faced by surgeons and of greatest concern because of risk of evisceration, the need for immediate intervention and the possibility of repeat dehiscence. Wound dehiscence carries with it a substantial morbidity and mortality. In addition, there is an increase in the cost, increased hospital stays, nursing and manpower cost in managing its complications.Methods: In this study a total 202 patients enrolled who underwent emergency and elective midline laparotomies. Patients clinically presenting as gaping of abdominal wound were included in study. Diagnosis was established by clinical examination. In all cases gentle probing of the wound with gloved finger done to confirm defect.Results: In this study incidence of burst abdomen was seen in 80 patients (39.6%) and was common in patients who underwent emergency surgeries. Patients who had stoma construction had maximum number of burst abdomen. 150 (74%) cases underwent emergency laparotomies in which 64 (42%) cases developed burst abdomen. In 60 cases closure done with re-suturing of fascia and remaining cases by skin closure only due to sepsis, poor general condition of patients. Mortality was seen in (22.5%) patients due to postoperative complicationsConclusions: Burst abdomen is more common in emergency surgeries than elective surgeries. Wound infection and stoma construction increase the rate of burst abdomen. Mid-mid line incisions have increased incidence of wound dehiscence. Mortality is high despite early treatment due to complications.
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Eghwrudjakpor, PatrickO, and Iseseoma Gbobo. "Burst abdomen following ventriculoperitoneal shunt placement." Journal of Pediatric Neurosciences 5, no. 1 (2010): 88. http://dx.doi.org/10.4103/1817-1745.66668.
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Fatima Shahab. "Comparison Between Continuous and Interrupted Fascial Closure in Emergency Midline Laparotomy." Indus Journal of Bioscience Research 3, no. 5 (2025): 917–23. https://doi.org/10.70749/ijbr.v3i5.1307.
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Objective: To compare the effectiveness of interrupted versus continuous fascial closure techniques in emergency midline laparotomy in terms of the frequency of burst abdomen. Study Setting: Department of Surgery, DHQ Hospital, Faisalabad. Duration of Study: July 31, 2024 to January 31, 2025 (Six months following approval of the synopsis) Data Collection: A randomized controlled trial was conducted on 150 patients undergoing emergency midline laparotomy. Patients were randomly assigned to either interrupted (n=75) or continuous (n=75) closure techniques. The primary outcome was burst abdomen, assessed over a 30-day postoperative period. Results: The incidence of burst abdomen was significantly lower in the interrupted closure group (4 cases, 20.0%) compared to the continuous closure group (16 cases, 80.0%) (p = 0.004). Stratified analysis showed that the continuous closure technique was associated with a significantly higher risk of burst abdomen across different age groups, gender, and BMI categories. However, there was no significant difference in superficial surgical site infections between the two groups (p = 0.273). Conclusion: Interrupted fascial closure significantly reduces the incidence of burst abdomen in emergency midline laparotomy compared to continuous closure. Given its effectiveness in preventing wound dehiscence, interrupted closure should be preferred in emergency settings. Further multicenter trials with extended follow-up periods are warranted to confirm long-term outcomes.
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Islam, Baharul, Saiful Islam, Subroto Kumar Roy, Nur Kutubul Alam, Tahmidur Rahman, and Md Habibullah Sarkar. "Interrupted Midline Fascial Closure to Prevent Burst Abdomen in Emergency Laparotomy: Comparison between Continuous and Interrupted closure." TAJ: Journal of Teachers Association 30, no. 2 (2018): 69–75. http://dx.doi.org/10.3329/taj.v30i2.39141.
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Burst abdomen represents one of the most frustrating and difficult postoperative complication that concerns every abdominal surgeon. It occurs because of various predisposing factors which can be prevented to some extend by having knowledge regarding them. Despite many years of experience, the optimal technique of laparotomy closure remains controversial. The varieties of surgical excess as well as the varieties of abdominal closure techniques are the main difficulties in the proper standardization of this procedure. In this paper a randomized prospective study was designed to compare with a interrupted and continuous technique for closing a midline abdominal fascia in emergency laparotomy. A total of 300 patients of acute abdominal condition who underwent laparotomy were randomized into two groups of 150 patients in each group. Total 22(7.33%) of 300 patients developed burst in the postoperative period. Fourteen (14) (9.33%) in continuous arms and eight (08) (5.33%) patients in interrupted arms developed burst. Burst abdomen occurring mostly 40-60 years age group with a male to female ratio of 1.68: 1. Cough, anemia, malnutrition, DM, intraperitoneal sepsis, wound infection, uremia and abdominal distension were the important predisposing factors for the incidence of burst abdomen. Interrupted suturing was associated with significantly reduced the burst abdomen when comparing with continuous closure.TAJ 2017; 30(2): 69-75
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Lotfy, Wael. "BURST ABDOMEN: IS IT A PREVENTABLE COMPLICATION?" Egyptian Journal of Surgery 28, no. 3 (2009): 128–32. http://dx.doi.org/10.21608/ejsur.2009.367598.
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Mukesh Kumar P, Sathyaraj P, Jemin Bharath R, Ramprasath S, and Renganathan M. "Comparative study between mass closure suturing technique and Hughes repair in emergency midline laparotomies." Asian Journal of Medical Sciences 14, no. 10 (2023): 235–39. http://dx.doi.org/10.3126/ajms.v14i10.54224.
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Background: The most alarming post-operative consequences for patients and doctors are wound infection and dehiscence. Post-operative wound infection and dehiscence lengthen the hospital stay after surgery. Aims and Objectives: The present study examined the incidence of wound infection, wound dehiscence, duration of hospital stay, and burst abdomen between conventional and Hughes repair techniques of midline laparotomy wound closure. Materials and Methods: A 12-month prospective study was performed in the General Surgery Department at Government Rajaji Hospital in Madurai. In total, 80 patients, divided randomly into two groups of 40 each, received emergency midline laparotomies for various reasons. The primary outcome measures the infection incidence, wound dehiscence, and burst abdomen at the end of 10 days by the assessing surgeon. Results: In the study group, 30 (75%) were males, and females were 10 (25%). In the control group, males were 29 (72.5%), and females were 11 (27.5%). The mean age in the study and control groups was 42.4±11.927 and 41.7±13.607, respectively. There was a significant difference in surgery duration between groups. Most patients, i.e., 27 (67.5%) and 19 (47.5%), had wound infection and dehiscence in the control group, respectively. There was a significant difference in wound infection (P=0.025), wound dehiscence (P=0.002), duration of hospital stay (P<0.001), and burst abdomen (P=0.02) between groups. Conclusion: Hughes repair is associated with less incidence of wound infection, wound dehiscence, burst abdomen, and duration of hospital stay compared to patients whose abdomen was closed using the conventional continuous technique.
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Chapple, W. D. "Dynamics of reflex cocontraction in hermit crab abdomen: experiments and a systems model." Journal of Neurophysiology 69, no. 6 (1993): 1904–17. http://dx.doi.org/10.1152/jn.1993.69.6.1904.
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1. Both stretch and release of the ventral superficial muscles (VSM) in the abdomen of the hermit crab, Pagurus pollicarus, activate the VSM motoneurons in the intact animal and in the isolated abdomen. 2. This reflex was studied by recording intracellularly from muscle fibers innervated by single motoneurons during stretch and release of the VSM. The three motoneurons of the right fourth segment respond to both stretch and release with a phasic burst lasting approximately 250 ms. The burst in the two tonic motoneurons has two components, a short burst lasting 10-20 ms, with a latency from the beginning of stretch of 60-90 ms, and a longer burst of variable length, with a latency of 120 ms. Ramp stretches of different amplitudes and velocities were used to show that the first component is proportional to the absolute value of the second derivative of force and the second component to the absolute value of the first derivative of force. 3. Stretch and release of the VSM also simultaneously evoke phasic bursts in the motoneurons of the dorsal superficial muscles and the VSM circular muscles (functional antagonists of the longitudinal VSM), as well as in contralateral homologues of the same segment and in ipsilateral homologues of the next anterior segment. The effect of this coactivation is to stiffen the abdomen in response to perturbations in any direction. 4. Stretch or release of phasic mechanoreceptors in the VSM evokes this reflex. Isometric electrical stimulation of the isolated muscle also activates them, showing that they are transducing changes in force and suggesting that they operate to increase muscle stiffness by positive feedback. 5. A mathematical systems model of this reflex, composed of two parallel pathways activating the motoneurons, was constructed. The first pathway produces a signal proportional to the absolute value of the second derivative of force, the second pathway a signal proportional to the first derivative of force. The sum of the signals from the two pathways is filtered by an adaptation process, which is followed by a low-pass filter representing muscle activation kinetics. The muscle activation signal is then fed back to multiple muscle force. 6. Simulations using this model generate the phasic bursts to stretch and release as well as reproducing the frequency dependence of this reflex. The predominant action of this reflex is to enhance muscle stiffness.
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Okpala, Amalachukwu M., Samuel A. Debrah, and Mohammed Mouhajer. "Burst abdomen in pregnancy: A proposed management algorithm." Ghana Medical Journal 50, no. 2 (2016): 115. http://dx.doi.org/10.4314/gmj.v50i2.10.
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Goda, Ashraf, Mohamed Nasr, Osama H. Gharib, and Mostafa B. Mohamed. "Component separation technique for closure of burst abdomen." Ain Shams Journal of Surgery 12, no. 1 (2014): 1–10. http://dx.doi.org/10.21608/asjs.2014.179586.
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Mokhtar, SherifM, Hesham Amer, and ShadyE Harb. "Burst abdomen: should we change the concept, preliminary study." Egyptian Journal of Surgery 36, no. 3 (2017): 199. http://dx.doi.org/10.4103/1110-1121.211706.
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O. Dare, A. U. Bako, O.C. Ezechi, F. "Burst abdomen following caesarean section: a preventable surgical complication." Journal of Obstetrics and Gynaecology 20, no. 6 (2000): 612–13. http://dx.doi.org/10.1080/01443610020001468.
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Kumar N, Pritesh, Lovenish Bains, Pawan Lal, Anurag Mishra, Mohd Yasir Beg, and Haraesh Maranna. "Role of intra-abdominal pressure in the outcomes of perforation peritonitis: A prospective observational study." Turkish Journal of Surgery 37, no. 3 (2021): 253–59. http://dx.doi.org/10.47717/turkjsurg.2021.4945.
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Objective: Intra-abdominal pressure (IAP) has been investigated for its role in causing morbidity and mortality, with various studies showing different degrees of correlation. There remains paucity of literature on this subject, applied to patients of perforation peritonitis, especially in the Indian subcontinent. Material and Methods: It is a prospective observational study involving 40 patients of perforation peritonitis undergoing exploratory laparotomy. IAP was measured as per WSACS (World Society of Abdominal Compartment Syndrome) guidelines. APACHE II (Acute Physiology And Chronic Health Evaluation- II) and SOFA (Sequential Organ Failure Assessment) were calculated. Data was collected regarding occurrence of prolonged ileus, burst abdomen, duration of hospital stay, 30 day mortality, and was statistically analyzed to correlate with IAP. Results: At admission, mean IAP was 13.37 mmHg, and the incidence of IAH was 65%. IAH was seen in 17.9% and 7.6% at 24 h and 48 h post-operatively. Incidence of prolonged ileus and burst abdomen were 7.7% and 22.5% respectively. Mortality rate was 17.5%. Mean duration of hospital stay was 13.45 days. Post-operative IAP correlated with mortality (p: 0.014) and post-operative SOFA score (p< 0.05). Statistically significant correlation was also seen with the occurrence of prolonged ileus (p: 0.006). IAP did not significantly correlate with APACHE II score, occurrence of burst abdomen, and duration of hospital stay. Conclusion: Rise in IAP correlates with deterioration of SOFA score, and also with the occurrence of prolonged ileus. IAP is also a predictor of mortality. IAP measured post-operatively (24 and 48 hours) had a better correlation with these outcomes than the value measured at admission. No statistically significant correlation of IAP with the occurrence of burst abdomen and duration of hospital stay could be found, which warrants further studies with a larger population.
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AHMGB, Abeysinghe, Senarathne R, and Wimalasena GADNB. "Successful Management of Abdominal Wound Dehiscence with Bogota bag, Vacuum assisted Closure combined with Tension Sutures." Journal of Surgical Case Reports and Images 4, no. 7 (2021): 01–04. http://dx.doi.org/10.31579/2690-1897/091.
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The burst abdomen management has advanced significantly. Here we present a management of a burst abdomen of morbid obese patient with combination of modality including Bogota bag, vacuum assisted closure and tension suturing. The patient underwent laparotomy for removal of sigmoid tumor with local infiltration and had wound dehiscence associated with infection, tissue oedema and necrosis. As patient was morbidly obese and had large wound gap, we decided to manage it with Bogota bag principal and Vacuum Assisted Closing. After successful formation of granulation tissue, we were able to apply tension sutures. Hence using combination of above-mentioned options, the patient was successfully sent back to his normal routines without any complication.
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Mulloney, Brian, Patricia I. Harness, and Wendy M. Hall. "Bursts of Information: Coordinating Interneurons Encode Multiple Parameters of a Periodic Motor Pattern." Journal of Neurophysiology 95, no. 2 (2006): 850–61. http://dx.doi.org/10.1152/jn.00939.2005.
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The limbs on different segments of the crayfish abdomen that drive forward swimming are directly controlled by modular pattern-generating circuits. These circuits are linked together by axons of identified coordinating interneurons. We described the distributions of these neurons in each abdominal ganglion and monitored their firing during expression of the swimming motor pattern. We analyzed the timing, the numbers of spikes, and the duration of each burst of spikes in these coordinating neurons. To see what information these neurons encoded, we correlated these parameters with the timing, durations, and strengths of bursts of spikes in motor axons from the same modules. During the power-stroke phase of each output cycle, the anterior-projecting neurons fired bursts of spikes that encoded information about the start-time, duration, and strength of each burst of spikes in power-stroke motor neurons from the same module. When the period and intensity of the motor output fluctuated, the bursts of spikes in these neurons tracked these fluctuations accurately. Each additional spike in these neurons signified an increase in the strength of the power-stroke burst. The posterior-projecting neurons that fired during the return-stroke phase encoded similar information about the return-stroke motor neurons. Although homologous neurons from different ganglia were qualitatively similar, neurons from posterior ganglia fired significantly more spikes per burst than those from more anterior ganglia, a segmental gradient that correlates with the normal posterior-to-anterior phase progression of limb movements. We propose that this gradient and a similar gradient in the durations of bursts in power-stroke motor neurons might reflect a hitherto-undetected difference in the excitation or intrinsic excitability of swimmeret modules in different segments.
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Yurtkap, Y., F. P. J. den Hartog, W. van Weteringen, J. Jeekel, G. J. Kleinrensink, and J. F. Lange. "Evaluation of a new suture material (Duramesh™) by measuring suture tension in small and large bites techniques for laparotomy closure in a porcine model." Hernia 24, no. 6 (2020): 1317–24. http://dx.doi.org/10.1007/s10029-020-02140-7.
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Abstract Purpose After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional hernia. The objective of this study was to measure the suture tension in small and large bites with a new suture material. Methods Closure of the linea alba was performed with small bites (i.e., 5 mm between two consecutive stitches and 5 mm distance from the incision) and large bites (i.e., 10 mm × 10 mm) with Duramesh™ size 0 (2 mm) and PDS II 2-0 in 24 experiments on six porcine abdominal walls. The abdominal wall was fixated on an artificial computer-controlled insufflatable abdomen, known as the ‘AbdoMan’. A custom-made suture tension sensor was placed in the middle of the incision. Results The suture tension was significantly lower with the small bites technique and Duramesh™ when compared with large bites (small bites 0.12 N (IQR 0.07–0.19) vs. large bites 0.57 N (IQR 0.23–0.92), p < 0.025). This significant difference was also found in favour of the small bites with PDS II 2-0 (p < 0.038). No macroscopic tissue failure was seen during or after the experiments. Conclusion Closure of the abdominal wall with the small bites technique and Duramesh™ was more efficient in dividing suture tension across the incision when compared to large bites. However, suture tension compared to a conventional suture material was not significantly different, contradicting an advantage of the new suture material in the prevention of burst abdomen and incisional hernia during the acute, postoperative phase.
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Mirza, Muhammad Afzal, Mohsin Riaz Askri, Shumyala Maqbool, and Sarfraz Ahmad. "MODIFIED DUHAMEL PROCEDURE;." Professional Medical Journal 25, no. 08 (2018): 1147–50. http://dx.doi.org/10.29309/tpmj/2018.25.08.62.
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Objectives: To evaluate the early complications of Martin’s Modified DuhamelProcedure. Design: Retrospective study. Period: January 2017–December 2017. Setting: TheChildren Hospital & Institute of Child Health, Faisalabad. Material and Methods: This studyincluded Eighty Six children who underwent Martin’s modification of Duhamel’s procedure fortreatment of Hirschsprung’s disease. Results: Early postoperative complications (with in 1st 30days of operation) were observed in 86 patients. The complications noted were bleeding (n=3),wound infection (n=20), burst abdomen (n=5), anastomotic leak (n=8), intestinal obstruction(n=4), early post-operative constipation (n=6), enterocolitis (n=6), soiling (n=5) and mortality(n=2). Conclusion: Early post-operative complications in the series included bleeding, woundinfection, burst abdomen, anastomotic leak, intestinal obstruction, constipation, enterocolitis,soiling and death. The complications rate in this study is comparable to the previous studies.
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Changole, Sanjay, Maheshkumar Soni, and Dattatray Thakare. "Peptic perforations: comparative study of its closure (omentopexy versus figure of 8 closure)." International Surgery Journal 6, no. 6 (2019): 2074. http://dx.doi.org/10.18203/2349-2902.isj20192369.
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Background: Peptic ulcer perforation is one the most common and catastrophic maladies that affect mankind. The aim of this study was to compare the surgical techniques of peptic ulcer perforation closure namely omentopexy and figure of 8 stitch with reference to recovery time and complications rate.Methods: Of 80 selected patients, figure of 8 method for closure of peptic perforation was used in 40 patients and 40 by using omentopexy method. Outcomes were compared in view of postoperative recovery time and postoperative complications such as wound complications, respiratory complications, burst abdomen, septicaemia, hospital stay, death.Results: In our study it was noted that age of presentation was in elderly males with risk factors like alcohol, smoking, tobacco chewing, and NSAIDS use in decreasing order. Late presentation was associated with higher complication including one death. In figure of 8 group it was found that RT Removal was early, early oral resumption loss hospital stay in figure of 8 group than in omentopexy group. Complications such as wound complication, burst abdomen , leak, and septicaemia were more in omentopexy group than figure of 8 group. Only one death occurred in study that was in omentopexy group.Conclusions: We came to conclusion that peptic perforation is more common in males around 50 years with risk factors of smoking and alcohol. Outcomes of surgery with figure of 8 stitch were better than omentopexy with respect to oral resumptions, early discharge, less complications such as wound complications, burst abdomen leak septicaemia and death.
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Rafiq, Muhammad Kashif, Haider Kamran, Babar Sultan, et al. "OUTCOME OF THE CHOICE OF WOUND CLOSURE TECHNIQUE IN EMERGENCY LAPAROTOMY." Journal of Ayub Medical College Abbottabad 34, no. 1 (2022): 164–68. https://doi.org/10.55519/jamc-01-8797.
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Background: Abdominal surgeries are the most common surgeries performed around the world. Closure of abdominal wound is important and a number wound closing techniques are in practice. This study was conducted to determine the outcome of the choice of wound closure technique in emergency laparotomy. Methods: It was a retrospective study from March-September 2019, conducted at the Surgical A unit, Ayub Teaching Hospital, Abbottabad. Ninety-five patients aged 22-60 years, who underwent emergency laparotomies via midline and para-median incisions were included in the study. Results: There were 74 (77.89%) males and 21 (22.11%) females. Anatomical closure technique was used in 67 (70.53%) of study participants while mass closure technique was used in 28 (29.47%) of study participants. 50 (52.63%) patients had anaemia, 27 (28.42%) had hypo-proteinemia, and 14 (14.74%) developed peritonitis. Post-operative wound infection was noticed in 15 (15.79%) patients. Out of 95 patients, 19 (20%) developed burst abdomen. Overall, 5 (5.26%) patients died in the hospital. All cases of burst abdomen occurred within first two weeks of hospital stay (p= 0.004), had an association with peritonitis (p=0.0001) and post-operative wound infection (p= 0.005). Wound closure technique was not associated with development of post-operative complications including burst abdomen (p >0.05). Conclusion: Post-operative complications occur independently of wound-closure technique and surgeons should have a low threshold for prevention of post-operative complications where possible.
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Rosdiana R, Agussalim Bukhari, Nurpudji A Taslim, and Mardiana Madjid. "PEMBERIAN PROTEIN YANG ADEKUAT MEMPERCEPAT PENUTUPAN BURST ABDOMEN PADA PASIEN GERIATRI DENGAN TUMOR KOLON." IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN) 1, no. 1 (2018): 37–47. http://dx.doi.org/10.54773/ijcnp.v1i1.29.
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Pendahuluan
 Burst abdomen adalah terpisahnya jahitan luka pada abdomen secara parsial atau komplit salah satu atau seluruh lapisan dinding abdomen pada luka post operatif disertai protrusi dan eviserasi isi abdomen yang merupakan komplikasi tindakan bedah karena tidak adekuatnya perawatan luka, pengobatan, dan dukungan nutrisi.
 Resume kasus
 Seorang laki-laki berumur 85 tahun, dikonsul dari bagian bedah digestif dengan diagnosis medis Burst abdomen post operasi laparatomi dan colostomi et causa tumor colon rectosigmoid, keluhan utama luka terbuka di perut dan asupan tidak adekuat, Riwayat penurunan berat badan kurang dari 5 kg selama 1 bulan terakhir. Buang air besar via colostomi. Pemeriksaan antropometri didapatkan LLA 18 cm. Pada pemeriksaan fisik ditemukan, anemia (+), Loss of subcutaneus fat (+), terdapat wasting pada keempat ekstremitas. Pemeriksaan laboratorium didapatkan deplesi berat sistem imun (874), hipoalbuminemia (2.6), anemia (9.6) dan hipokalemia (2.9). Kebutuhan Energi Terkoreksi : 1394 kkal dengan komposisi makronutrien: Protein: 1,7 gr/kg BBI/hari = 79.92 gr =22%, Karbohidrat : 55%= 192,5 gr, Lemak : 23% = 35,7gr. Penatalaksanaan nutrisi perioperatif yang diberikan bertujuan sebagai manajemen nutrisi perioperatif, meningkatkan status gizi dan memperbaiki status metabolik pasien, mempercepat penyembuhan luka dan memberikan edukasi gizi ke pasien. Operasi repair wound dilakukan dengan nilai PNI 36,5.Pada hari ke-13 post operasi terjadi dehisensi luka. Peningkatan pemberian protein sebesar 2 gram /kgBBI/hari karena tidak adanya peningkatan kadar albumin. Setelah diintervensi pada hari ke 35 post operasi mulai terjadi perbaikan luka operasi. Pada pasien ini juga dilakukan program peningkatan berat badan( penambahan kalori secara bertahap dengan maksimal pemberian sebesar 1000 kkal) untuk perbaikan status gizi . Pada Monitoring dan evaluasi asupan membaik, antropometri terjadi peningkatan (LLA 20,5cm)dan pada pemeriksaan laboratorium didapatkan perbaikan kadar TLC (2.769), albumin (3,8) dan kalium (5,3) serta kadar Hb (11).Lama perawatan perioperatif 100 hari.
 Kesimpulan
 Intervensi nutrisi yang optimal, monitoring serta edukasi gizi diperlukan untuk menunjang perbaikan kondisi klinis pasien pre dan post operatif dengan burst abdomen. Intervensi nutrisi yang optimal, monitoring serta edukasi gizi yang baik menunjukkan adanya perbaikan asupan kalori, status metabolik sehingga dapat mengurangi risiko infeksi, lama rawat dan mortalitas yang berefek pada perbaikan luka.
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Choudhury, Chishti Tanhar Bakth, Jamal Ahmed Chowdhury, and Mrigen Kumar Das Chowdhury. "Superior Mesenteric Artery occlusion presenting with severe acute abdomen and subsequent gangrenous small gut." Bangladesh Critical Care Journal 5, no. 2 (2017): 141–42. http://dx.doi.org/10.3329/bccj.v5i2.34399.
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Superior Mesenteric Artery occlusion is not very uncommon in developing world . It mimic clinically with many differential diagnosis.2 There is a clinical scenario of 60 yrs male, smoker presented in Accident & Emergency (A&E) department with history of central abdominal pain for two days associated with vomiting. Pain was gradually increasing, abdomen became tense, tender and patient developed restlessness. Even after all sorts of conservative management, pain was not subsiding. Following day of admission laparotomy attempted with clinical vision of burst appendix and peritonitis. After exploration of abdomen the finding was thundering. The almost whole small gut was gangrenous , resection anastomosis had done. In this case the differential diagnosis was burst appendix and Intestinal obstruction . Possibility of Superior Mesenteric Artery occlusion should be kept in mind by this clinical ground .Bangladesh Crit Care J September 2017; 5(2): 141-142
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Israr, Sana, Muhammad Kamran Khan, Anila Farid, Nadia Qaiser, Kalsoom Akhtar, and Aisha Jalal. "Frequency of Abdominal Wound Dehiscence /Burst Abdomen in Patients of Laparotomy." Pakistan Journal of Medical and Health Sciences 16, no. 9 (2022): 772–74. http://dx.doi.org/10.53350/pjmhs22169772.
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Background: Wound dehiscence is a surgical problem in which a wound crack along a surgical incision. It is sometimes called wound disruption, wound breakdown or wound separation. Objective: To find out the frequency of abdominal wound dehiscence in patients with laparotomy. Study design: Descriptive cross sectional study. Material and methods: 385 patients having age of 12-70 yrs with sign of laparotomy have participated such that blunt abdominal trauma, fire arm injury and peritonitis. Patients had been admitted in the surgical unit. After comprehensive history, complete physical and systematic examination have been done. Data was analyzed using SPSS version 10.0.For indication of laparotomy and wound dehiscence, frequency and percentage were presented. Result: 263 male (68.31%) and 122 female (31.69) participated in study. Mean age was 35.72 ±12.732. About 4.42% (n=17) patients had abdominal wound dehiscence. In 12-30 years age group, 4/152 patients had abdominal wound dehiscence. Among the age group 31-50 years,7/177 patients and in age 51-70 years,6/56 patients had wound dehiscence. Conclusion: In laparotomy patients, abdominal wound dehiscence is prominent obstacle that can be noticed pre operatively and genuine measurements should be taken to lessen its frequency. Keywords: Wound dehiscence, laparotomy, peritonitis
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Brajesh, Kumar, Kumar Brajkishor, and Alam Khursheed. "Comparison of Continuous versus Interrupted Abdominal Wall Closure Techniques after Emergency Midline Laparotomy: A Randomized Controlled Trial." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 454–62. https://doi.org/10.5281/zenodo.12732506.
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<strong>Background: </strong>This research aims to compare the outcomes of continuous and interrupted abdominal wall closure techniques in emergency midline laparotomy, specifically focusing on the incidence of incisional hernia and ruptured abdomen as the key endpoints. <strong>Aim: </strong>Comparison of continuous and interrupted abdominal wall repair techniques after emergency midline laparotomy. <strong>Material and Methods: </strong>Patients who had undergone laparotomy in the past and were scheduled for a second look procedure were not included in the study. However, patients who had undergone minor laparoscopic surgery in the past were included. The 100 patients were evenly split into two groups, with 50 patients in each group. Both groups were required to maintain a maximum stitch spacing of 1.5 cm and a minimum distance of 2 cm from the border of the fascia. The patients in the continuous suture group had their abdomen closed using a continuous, all-layer suture technique. <strong>Results: </strong>The average length of hospitalization was comparable across the two groups (C: 17.45 ± 14.58 days, I: 18.94 ± 14.12 days). 8.21% of patients had laparostomy, resulting in their exclusion from further investigation of hernia/dehiscence. The incidence of burst abdomen after 30 days or incisional hernia after 12 months did not vary between the continuous and interrupted groups. In the continuous group, 16% had burst abdomen or incisional hernia, whereas in the interrupted group, 22% experienced these complications. The total mortality, regardless of the reason, was 34 individuals. There was no significant difference in mortality between the groups, with 10 individuals (16.9%) in both the control group (C) and the intervention group (I). The p-value for this comparison was 0.24. The duration required for fascial closure was much shorter in the continuous group compared to the interrupted group (C: 13.66 ± 5.10 min versus 18.14 ± 5.96 min; p < 0.001). <strong>Conclusion: </strong>This randomized controlled trial (RCT) demonstrated that there was no discernible difference in the occurrence of postoperative burst abdomen and incisional hernia after one year when comparing the use of continuous sutures with slowly absorbable sutures with interrupted sutures with fast absorbable sutures in main emergency midline laparotomy.
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Ojuka, K. D., F. Nangole, and M. Ngugi. "Management of Anterior Abdominal Wall Defect Using a Pedicled Tensor Fascia Lata Flap: A Case Report." Case Reports in Medicine 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/487126.
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Degloving injuries to anterior abdominal wall are rare due to the mechanism of injury. Pedicled tensor fascia lata is known to be a versatile flap with ability to reach the lower anterior abdomen. A 34-year-old man who was involved in a road traffic accident presented with degloving injury and defect at the left inguinal region, sigmoid colon injury, and scrotal bruises. At investigation, he was found to have pelvic fracture. The management consisted of colostomy and tensor fascia lata to cover the defect at reversal. Though he developed burst abdomen on fifth postoperative day, the flap healed with no complications.
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Pandey, Vinod Kumar, Dhruv Chandra, Raj Kumar, et al. "Role of subcutaneous vacuum suction drain in prevention of abdominal wound complication in emergency laparotomy." International Surgery Journal 7, no. 6 (2020): 1873. http://dx.doi.org/10.18203/2349-2902.isj20202399.
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Background: Some of the most common wound complications following laparotomy include hematoma formation, seroma formation, wound infection, burst abdomen and wound dehiscence. Closed-suction drains (CSDs) help to drain any wound collection and also reduce any dead space in the wound thereby promoting healing and preventing complication.Methods: We conducted a prospective study and included patients presenting with acute abdomen in emergency department. Patients were selected as per inclusion and exclusion criteria. Two groups (group A and B) with equal number of patients were created based on closed envelope technique. CSD was placed in the wound of patients in group A. Wound healing and complications were compared between the two groups.Results: 50 patients were included in the study with 25 in each group. Hematoma formation was found to be significantly more among group B (24.0%) compared to group A (4.0%). Seroma formation (p value =0.03917), SSI rate (p value =0.039) and wound dehiscence/burst abdomen (p value =0.0415) was more in group B than group A. The mean wound healing time (days) and mean hospital stay (days) was significantly more in group B.Conclusions: Placing a subcutaneous vacuum suction drain at the time of abdominal wall closure during emergency laparotomy results in better wound healing and reduces postoperative wound complication, hospital stay time, morbidity and also decreases overall healthcare cost.
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Bijjaragi, Bhagyashree, and Amulya M. N. "Re-laparotomy in OBG: a clinical study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 4 (2018): 1367. http://dx.doi.org/10.18203/2320-1770.ijrcog20181021.
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Background: If laparotomy done within 60 days of primary surgery for the original disease it is called re-laparotomy. Aim of this study was to determine the risk factors causing re-laparotomy, the indications, management and outcomes of re-laparotomy.Methods: The study was conducted in the department of Obstetrics and Gynaecology, Vijayanagar Institute of Medical Sciences Hospital, Bellary, Karnataka. It is a 2 year prospective observational study of all the patients with re-laparotomy following operation done for obstetric or gynaecological indications.Results: Total 4105 patients underwent major surgery in two years between October 2013 to September 2015. Re-laparotomy was done in 10 cases. The incidence of re-laparotomy was 0.25% which is mainly for subacute intestinal obstruction, intraperitoneal haemorrhage, burst abdomen, PPH, rectus sheath hematoma.Conclusions: Hemorrhage, burst abdomen, infections are the main reasons for re-laparotomy after obstetric and gynaecological surgeries. Though the incidence of re-laparotomy is low and the outcome is favourable, several measures must be undertaken to prevent re-laparotomy such as careful surgical technique, meticulous hemostasis and strict asepsis should be maintained.
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Giuseppe, Garcea, Sutton Christopher D., Pattenden Clare J., Neal Christopher P., Berry David P., and Dennison Ashley R. "SUCTION DRAIN RETENTION SUTURES IN THE CLOSURE OF THE ACUTE BURST ABDOMEN." ANZ Journal of Surgery 77, no. 6 (2007): 495. http://dx.doi.org/10.1111/j.1445-2197.2007.04105.x.
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Aziz, Mahmoud A., Ahmed Elghrieb, Mohamed E. Abdu, and Mohamed M. Mahmoud. "Impact of anterior component separation technique on lowering the incidence of abdominal wall dehiscence and incisional hernia after emergent laparotomy: a feasibility study." Egyptian Journal of Surgery 43, no. 1 (2024): 22–28. http://dx.doi.org/10.4103/ejs.ejs_238_23.
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Introduction Abdominal wall dehiscence is one of the critical postoperative complications following abdominal surgeries. Emergency surgery highly contributes to the incidence of a burst abdomen due to a lack of proper preoperative preparation and the presence of intraabdominal sepsis. Anterior component separation was primarily evolved in abdominal wall reconstruction in the open abdomen and huge ventral hernia repair. Methods This prospective study included 50 patients operated by midline laparotomy for non-traumatic abdominal emergencies. Anterior component separation technique was randomly applied in 25 patients before laparotomy closure, the other 25 patients were closed using the traditional midline closure method. Preoperative patient’s demographics, operative time, and different postoperative complications were reported. Incidence of burst abdomen in both groups was reported. Results Preoperative patient’s demographic data showed no significant difference between both groups; the mean age of the patients was 53.69±7.34. Operative time was significantly longer in the Anterior Components Separation (ACS) group (P<0.001). The incidence of abdominal wall dehiscence after ACS technique (4.3%) was significantly less than after traditional technique (24%). Postoperative seroma and hematoma were the common postoperative complications after ACS however the incidence was not statistically significant. Incisional hernia was detected in (13.04%) in ACS group and in (32%) in traditional group. Conclusion Application of ACS technique during laparotomy closure in abdominal emergencies seems to lower the incidence of abdominal wall dehiscence with no increase in different postoperative complications.
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Begum, Jasmin, AZM Forman Ullah, Iftekharul Islam, Md Al Amin Chowdhury, Md Abdulla Al Mansur, and Utpak Kumar Das. "Comparison between Interrupted X Suture and Continuous Suture for Closure of Midline Incision in Emergency Laparotomy : A Randomized Controlled Trial." Chattagram Maa-O-Shishu Hospital Medical College Journal 21, no. 2 (2022): 52–56. http://dx.doi.org/10.3329/cmoshmcj.v21i2.63130.
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Background: Wound dehiscence is disruption of any or all of the layers in a wound. At around 7–10 days post operatively leakage of clear sero-sanguinous fluid from the wound is usually the first indicator of burst abdomen. The patient usually feels something ‘giving away’ at this time.It may occur in 3-14.5% cases and is very distressing to the patient.Number of methods of closure of midline laparotomy wound have been introduced in the past to prevent this outcome. The study to compare the result of continuous and interrupted closure of midline emergency laparotomy in respect of burst abdomen.
 Materials and methods: This randomized controlled trial study was carried out in the Department of Surgery Chittagong Medical College Hospital, Chattogram, duration January 2017 to December 2017. A total of 500 patients were enrolled in this study. Data were collected, statistical analyses were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-23).
 Results: 250 patients in group A and 250 in B. Surgical wound related post-operative complications were found in 30.4% of the study subjects (n=152).Wound dehiscence was found in 11% subjects, surgical site infection was found in 18.4% subjects and incisional hernia in 1%.All these complications were significantly higher in continuous suture group than interrupted group (p<0.001).Wound dehiscence in 20 subjects, treated with interrupted sutures and in 40 subjects (35 wound dehiscence and 5 incisional hernia)treated with continuous suture. The Relative Risk (RR) of developing wound dehiscence post-operatively was found to be 0.63 (95% CI 0.33 – 0.72) for interrupted suture. This was statistically significant (p<0.05).
 Conclusion: The interrupted X suture technique is better than continuous suture technique in prevention of burst abdomen in emergency midline laparotomy.
 Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 52-56
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Esmat, M. Emad. "A New Technique in Closure of Burst Abdomen: TI, TIE and TIES Incisions." World Journal of Surgery 30, no. 6 (2006): 1063–73. http://dx.doi.org/10.1007/s00268-005-0450-x.
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Aguilar-Barragán, Cuauhtémoc, Salma Angélica Cedeño-González, Samantha Colchado-Mariscal, et al. "Pneumatosis Intestinalis: Cause of Intraabominal Free Gas as no Urgent Surgical Management. Case Report and Review of Literature." SAR Journal of Surgery 5, no. 04 (2024): 29–33. http://dx.doi.org/10.36346/sarjs.2024.v05i04.001.
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Pneumatosis intestinalis is a rare disease by the presence of multiple gas-filled cysts in the intestinal wall, which eventually could burst and release the gas into de abdominal cavity that can simulate and acute abdomen event. The etiology is not well known but it is attributable to rheumatologic diseases. To correctly manage the patients affected with this pathology is important to differentiate the candidates to conservatively versus surgical management.
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Singla, Anjali, A. R. Bansal, Vishal Chopra, Divyasha Chopra, and Joy Bansal. "Which suture is ideal for abdominal fascial closure: polydioxanone or polypropylene?" International Surgery Journal 10, no. 4 (2023): 647–50. http://dx.doi.org/10.18203/2349-2902.isj20230970.
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Background: A secured fascial closure with appropriate suture material is an integral step to prevent complications in laparotomy. A costly post-operative complication is wound dehiscence which manifests as incisional hernia as a delayed complication. The present study compared prolene and polydioxanone (PDS) sutures in patients undergoing midline closure after emergency exploratory laparotomy with the aim to evaluate wound outcome after the use of either of the sutures. Methods: Sixty-six patients undergoing emergency laparotomy were randomly divided into two groups: group A (PDS) and B (prolene). Wound complications were evaluated for each patient in terms of wound pain, wound discharge, burst abdomen, stitch sinus, stitch granuloma and incisional hernia. Results: Wound pain was observed more in prolene group, p<0.05 till 3rd post-op day. Wound discharge, wound dehiscence and burst abdomen were more in prolene group, but the difference was statistically insignificant (p>0.05). Six patients developed incisional hernia, out of which 5 had prolene, (p>0.05). Similar statistically insignificant difference was found with stitch granuloma and stitch sinus. Conclusions: Till date there is lack of agreement about the ideal suture for abdominal fascial closure. Present study concluded that any suture material is equally effective for abdominal fascial closure since there are many other factors contributing towards wound complications.
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Kareem, Talha, Muhammad Farrukh Aftab, Junaid Hashmi, Waqas Anjum, Hasaan Rafique, and Ali Rabbani. "Study of antibiotic resistance in patients of enteric perforation in a tertiary care hospital." Professional Medical Journal 28, no. 02 (2021): 141–46. http://dx.doi.org/10.29309/tpmj/2021.28.02.4901.
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Objective: To study the clinical outcomes and determine the antibiotic resistance in patients of enteric perforation in a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of General Surgery at Nishtar Hospital, Multan. Period: May 2017 to December 2019. Material & Methods: Sample size was calculated to be 97 with a confidence level of 95% and margin of error of 10%. We collected data from 100 patients. All the surgeries were done by the same team of consultant surgeons. The abdomen was closed by the same surgical team using the same surgical technique to avoid any bias. All the continuous variables were reported as mean ± standard deviation. The antibiotic resistance was compared with the number of patients with wound infections, burst abdomen, ICU admissions and number of in-hospital stay days. Categorical variables were compared using Chi square test for Independence. The number of in-hospital stay days were compared using Student t-test. The results were compiled using SPSS version 20. Results: Our result indicated that a patient had a greater chance of having a burst abdomen and wound infection if there was resistance to ciprofloxacin or ceftriaxone. Similar results were obtained for ICU admissions. There was a significantly longer in-hospital stay observed for patients who were resistant to the standard regimen of Ceftriaxone. Conclusion: It seems only rationale that the patients susceptible should be treated with Imipinem for 2 weeks as the empirical therapy rather than the standard empirical therapy of ceftriaxone and ciprofloxacin. The blood cultures can be sent before starting Imipinem and treatment management plan changed if the culture results are sensitive for the empiric antibiotics.
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Dr, Nazish Tanveer Dr. Rabeea Irfan Dr. Farhana Shabbir. "A CROSS-SECTIONAL RESEARCH TO COMPARE THE VARIOUS POSTOPERATIVE COMPLEXITIES OCCURRENCE IN SECONDARY ADVANCED PERITONITIS AFTER ILEOSTOMY." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES o6, no. 03 (2019): 6480–84. https://doi.org/10.5281/zenodo.2604511.
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<strong><em>Background: </em></strong><em>Since ancient times, depletion of body cavities has been used in medicine. For many years, there has been a dispute related to the use of peritoneal drainage in patients with diffuse peritonitis.</em> <strong><em>Objective: </em></strong><em>To compare the occurrence of different postoperative complexities in secondary advanced peritonitis after ileostomy because of enteric excavate with or without drains, was the objective of this study.</em> <strong><em>Patients and Methods: </em></strong><em>This research was carried out at Mayo Hospital, Lahore from February 2017 to October 2017. The patients selected for the study were having peritonitis for above 48 hours. In all the participants, ileostomy was carried out. All patients were divided into two categories. Group – A include patients with transperitoneal drainage. Whereas, Group – B contains patients without drainage. Those patients were excluded from this study who were found with primary repair.</em> <strong><em>Results: </em></strong><em>Total patients included in this study were 50. The percentage of males and females was 56% and 44% respectively with a male to female ratio of (1.27:1). The mean age of patients was (24.75 ± 10) years. All these patients were having secondary peritonitis due to typhoid excavation (with a history of systemic toxicity). These patients need ileostomy with or without gut resection. For group A, mean postoperative hospital stay was (9.5 ± 0.5) while for group B it was (6.5 ± 0.51) was mean hospital stay. Drainage was carried out in 24 patients; whereas, 26 patients were without drainage (Group A & B). Comparative to three patients of Group – B wound infection was developed by five patients of Group – A. Comparative to Group – B, patients of Group – A who got burst abdomen, intra-abdominal collection and chest infection were one, two and one respectively.</em> <strong><em>Conclusion:</em></strong><em> In patients in whom drain was inserted, the incidence of complexities such as intraabdominal collection, pulmonary infections and burst abdomen was high. Still there observed no advantage of drainage of peritoneal cavity in secondary advanced peritonitis.</em> <strong>Keywords: </strong><em>Resection, Drainage, Postoperative, Ileostomy, Burst Abdomen, Infection and Peritoneal.</em>
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A.Walmiki, Deepika, Anil R., Rajashekhar T. Patil, and Sunil Telkar. "A PROSPECTIVE STUDY TO COMPARE CONTINUOUS VERSUS INTERRUPTED SUTURE IN PREVENTION OF BURST ABDOMEN." International Journal of Advanced Research 11, no. 03 (2023): 565–71. http://dx.doi.org/10.21474/ijar01/16463.
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Aims And Objectives: The present study was undertaken to assess theproportion of burst abdomen in post midline laparotomy patient usinginterruptedXsuturesversuscontinuoussuturetechniqueinsheathclosure. Materials And Methods: A total of 50 patients undergoing midlinelaparotomyinemergencysettings,fromtheDepartmentofGeneralSurgery, Gadag Institute of Medical Sciences, Gadag, whose satisfying inclusion and exclusion criteria after takingwritten and informed consent were divided in to two groups of 25 each.In group A closure was performed using No.1 prolene suture, usinginterrupted X type, and in group B closure was done by continuousmethod,andthesepatients werefollowedupin thepostoperativeperiod. Results: Patients were followed up in the early post operative periodand regular follow up. 3 of the patients developed wound dehiscence, incontrastwithcontrolgroupinwhich9patientsdevelopedburstabdomen. 1 of our patients from the study group developed incisionhernia,7 from control group developed incision hernia. In the presentstudy 22patientsin whom interruptedXsuturingwasdonehadanormal wound healing compared to 16 patients with continuous group.5 patients from the interrupted group had a prolonged hospital staycomparedto11patientsfromthecontinuousgroup.Therefore,Interrupted X suturing technique overweighs the disadvantages of thecontinuoussuturingtechnique.Hencethetechniqueshouldbeconsidered. Conclusion:HenceInterruptedXsutureisbetterthancontinuoussheathclosureinpreventionofburstabdomen.
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Hermawan, Gezta Nasafir, Jacobus Jeno Wibisono, and Lidya F. Nembo. "Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice." Medicinus 8, no. 3 (2021): 102. http://dx.doi.org/10.19166/med.v8i3.3767.
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<p>Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.</p>
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Kunju, Rahul D., Vinayak Thakkannavar, Shrivathsa Merta K., et al. "A clinical study of continuous and interrupted fascial closure in emergency midline laparotomy at a tertiary care centre." International Surgery Journal 4, no. 6 (2017): 2014. http://dx.doi.org/10.18203/2349-2902.isj20172403.
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Background: Commonest approach in emergency open abdominal surgeries remains to be midline laparotomy because it is simple, saves time and causes minimal blood loss. Optimal technique for laparotomy wound closure has been a topic of debate since long. Risk factors for development of incisional hernia and burst abdomen are wound infection, systemic illnesses of patient and closure technique. Factors related to patients like age, gender, body mass index (BMI), systemic illnesses are not modifiable when an emergency laparotomy is the only option. Hence closure technique is one factor where surgeon has total control, which can bring down the incidence of burst abdomen and incisional hernias.Methods: Prospective study conducted in 150 patients who underwent emergency midline laparotomy from December 2014 to February 2016 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India with 6 months’ follow-up after surgery.Results: Most of patients in the study belonged to 30-40-year group and were males (78%). Gastrointestinal perforation peritonitis (52%) was the single most common indication for emergency midline laparotomy. In the continuous and interrupted groups, post-operative wound infection was found in 54.6% and 34.6%, wound dehiscence was found in 16% and 6.6% and incisional hernia in 14.4% and 4% respectively.Conclusions: Interrupted suturing is superior to continuous technique in emergency midline laparotomy wound closure in terms of complications and post-operative morbidity.
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Chapple, W. D. "Reflex control of dynamic muscle stiffness in a slow crustacean muscle." Journal of Neurophysiology 54, no. 2 (1985): 403–17. http://dx.doi.org/10.1152/jn.1985.54.2.403.
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The properties of a stretch reflex in the ventral superficial muscle of the hermit crab abdomen were studied in an isolated abdominal preparation to determine how the reflex affects the mechanical properties of the muscle and whether the reflex is controlling length, force, or stiffness. The reflex was elicited by stretch of hypodermal mechanoreceptors in the cuticle and resulted in the activation of excitor motoneurons to both circular and longitudinal layers of the muscle, thus stiffening the abdomen. The medial motoneuron of the longitudinal layer of the right fourth segment was selected for detailed analysis. It was tonically active and responded to stretch with a phasic burst having a latency of 100 ms. Reflex muscle tension began to increase at 130 ms and reached a peak at 300 ms. Reflex-burst frequency increased slightly with stretch amplitude. Peak force was an approximately linear function of stretch amplitude. No tonic component to the reflex was found in the medial motoneuron, in the central motoneuron (the smallest excitor to the muscle), or in the medial motoneuron studied in intact animals. The reflex-burst frequency was a function of stretch velocity, increasing between two and one-half to four times for a 10-fold increase in stretch velocity. Peak force was essentially independent of stretch velocity over this range. The reflex-burst frequency was not a function of the initial length of the muscle on the ascending limb of the length-tension relation. Active peak force (between two and three times passive peak force) was relatively constant over this range. The dynamic active stiffness (the resistance to stretch of the muscle when the nervous system was intact) was separated into two components. One component is that due to the tonic frequency of the motoneurons, the other to the reflex burst. The reflex component makes up a substantial part of the total active stiffness. Dynamic active stiffness is relatively constant under the conditions of these experiments and, when normalized, is similar to that observed in mammalian myotatic reflexes. This constancy, however, cannot be due to negative feedback control of stiffness, as in mammals. It is suggested that constant reflex stiffness arises from the combination of the low-pass filter characteristics of the muscle and the high-pass filter characteristics of the reflex over a restricted range of velocities.(ABSTRACT TRUNCATED AT 400 WORDS)
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Sayak Roy, Kanchan Kundu, Susavan Das, and Shib Shankar Kuiri. "Comparative study between continuous and interrupted suturing for rectus sheath closure in exploratory laparotomy." Asian Journal of Medical Sciences 13, no. 5 (2022): 177–82. http://dx.doi.org/10.3126/ajms.v13i5.42155.
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Background: Exploratory laparotomy is a major surgical procedure. Midline laparotomy is the most common technique of opening the abdomen as it is simple, provides adequate exposure to all four quadrants, and affords quick exposure with minimal blood loss. Laparotomy wounds have been closed in various ways in terms of continuous versus interrupted closure, single layer versus mass closure, and absorbable versus non-absorbable sutures. Aims and Objectives: The aim of the study was to find out the technique of rectus sheath closure in patients undergoing exploratory laparotomy that can reduce the burden of complications in post-operative period. Materials and Methods: It is a hospital-based prospective randomized observational study which was conducted in a rural-based tertiary care hospital and medical college with a time frame of about 1½ years. A total number of 74 patients of adult age group (21–70 yrs) admitted in general surgery ward of Bankura Sammilani Medical College and Hospital, undergoing exploratory laparotomy. Results: Thirty-seven (50%) patients of midline laparotomy were closed in continuous technique. Rest 37 (50%) patients were closed in interrupted technique. The hospital stay was similar in both groups. There was no significant difference in incidence of wound infection (P=0.4687). Wound dehiscence and requirement of burst abdomen repair was significantly higher in continuous suture group as compared to interrupted suture group, but mean closure time (P<0.0001) and mean suture length (P=0.0436) were significantly higher in interrupted suture group. Conclusion: The major complication of emergency laparotomy is wound dehiscence which leads to increased morbidity and subsequent requirement of re-operation of burst abdomen and hospital cost. In our study, we found that interrupted suturing method of abdominal closure is better in respect to major post-operative complications though it requires more suture length and time.
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Bharti, Shiv Vansh, and Anup Sharma. "A Prospective Study Comparing Continuous Versus Interrupted Suture Techniques in Midline Abdominal Wound Closure." Journal of Nepalgunj Medical College 18, no. 1 (2020): 63–66. http://dx.doi.org/10.3126/jngmc.v18i1.35193.
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Introduction: Wound closure after midline laparotomy is an essential part of surgery to produce a healthy and a strong scar. There is an alternative interrupted method of closure as compared to conventional continuous method of closure. Many comparative studies have shown different outcomes. So, we wanted to evaluate the outcome of different techniques in our setting. Aims: To compare the outcome of Interrupted abdominal closure and continuous abdominal closure in midline laparotomy wound. Methods: This was a prospective comparative study conducted in the Department of Surgery of Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal for a duration of 1 year. A total of 60 patients were selected randomly to receive either continuous or interrupted abdominal closure in midline laparotomy wound. Wound was evaluated in terms of wound discharge, infection and wound dehiscence. Results: The mean age of the patients was 38.38 years. Most commonly, the patients presented with duodenal ulcer perforation with peritonitis. The average time taken for abdomen closure in group A (16.77 minutes) was significantly less as compared to group B (27.77 minutes). The average cost of sutures for group B (Rs 1322.97) was higher than that of sutures for group A (Rs 1118) with p value of <0.01. Wound infection and incidence of burst abdomen were similar in both groups after one month, suture sinus was seen in three patients of group A and four patients of group B (p = 1.0). Incisional hernia was seen in one patient of group A and in none of the patients of group B at three month’s follow-up (p = 1.0). Conclusion: Continuous technique of midline laparotomy wound closure is better in terms of time required for wound closure and costing of suture materials, while showing no difference in terms of wound infection, burst abdomen and late wound complications
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Bari, Zaki Ibne, Farjana Rashid, Mahedi Afroz Shakil, et al. "Effectiveness of Modified Smead Jones Technique Over Conventional Mass Closure for Midline Incision in Emergency Laparotomy." Asian Journal of Medicine and Health 23, no. 5 (2025): 124–32. https://doi.org/10.9734/ajmah/2025/v23i51230.
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Background: One of the major complications of emergency laparotomy is wound dehiscence, which is the separation of the abdominal wall layers after surgery. Wound dehiscence can lead to evisceration, infection, sepsis even death and requires second surgical intervention and prolonged hospitalization. This study compared effectiveness of modified Smead Jones closure in emergency midline laparotomy with peritonitis and to compare the incidence of wound infection, wound dehiscence, burst abdomen, wound sinus and incisional hernia with conventional techniques. Materials and Methods: This quasi experimental study was conducted at department of surgery, Mymensingh Medical College and Hospital, over twelve months (March, 2022 to February, 2023), on patients who underwent laparotomy with generalized peritonitis and allocated into two groups: one with conventional midline closure and other with modified Smead Jones technique. Postoperative complications like surgical site infection, wound dehiscence, burst abdomen, wound sinus and incisional hernia were recorded. Demographic and clinical data were collected by semi structured case record form and analysis was done with the help of SPSS (Statistical Package for Social Science) version-27. Results: The study encompassed total 152 participants, 76 in Group A (conventional closure) and 76 in Group B (Modified Smead Jones closure). Mean BMI values were 25.9±2.62 for Group A and 25.6±2.89 for Group B. Postoperative complications showed that the rates of surgical site infection (23.7% in Group A vs. 21.1% in Group B, p = 0.697), wound dehiscence 15.8% in Group A and 7.9% in Group B (p = 0.132), burst abdomen (9.2% in Group A vs. 5.3% in Group B, p = 0.348) and the rates of wound sinus (1.3% in Group A vs. 3.9% in Group B, p = 0.311) were not statistically significant. The most notable result was the significantly lower incidence of incisional hernia in Group B compared to Group A (9.2% in Group A vs. 1.3% in Group B, p = 0.029). Pain severity was predominantly mild, with 75.0% in Group A and 71.1% in Group B. The mean duration of hospital stay was significantly shorter in Group B (5.13 ± 2.10 days) compared to Group A (6.29 ± 3.07 days), with significant p value (p = 0.007). Conclusion: The Modified Smead Jones closure demonstrated statistically significant advantage in terms of a shorter hospital stay and reducing the incidence of incisional hernia compared to conventional closure. These findings underscore the promising aspects of the Modified Smead Jones technique and suggest its consideration in emergency laparotomies.
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Ayesha Mehboob, Sughra Parveen, Mazhar Iqbal, Kehkashan Anwar, Jehangir Ali, and Kulsoom Moulabux. "Outcome of Acute Peritonitis Related To Cause and Duration Of Presentation." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 18, no. 1 (2022): 9–14. http://dx.doi.org/10.48036/apims.v18i1.529.
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Objective: To determine the outcome of acute cause-related peritonitis correlated with the duration of inflammation within 24, 24-48, and after 48 hours of hospital admission. Methodology: This quasi experimental study was conducted at Surgical Ward #3, Jinnah Postgraduate Medical Centre from September 2019 to March 2021. Patients over 12 years old were included in this study. The duration, cause, and outcomes of peritonitis were noted. All complications were recorded and treated accordingly. Results: 136 patients between the ages of 13 to 80 years old were included, 104 were males (76.8%) and 32 females (23.18%). 37 patients (28.2%) were aged 13–20 years, 61 (44.2%) were aged 21–40, 33 (23.91%) were aged 41–60, and 5 (3.6%) were aged over 60 years. Mortality showed 2 patients (1.47%) expired in 24–48 hours, and 6 (4.4%) in 48 hours. The cause of peritonitis included typhoid ileal perforation (41%), duodenal perforation (33%), ruptured appendix (28%), intestinal tuberculous (14%), gangrenous gut (7%), tumour perforation (6%), liver abscess (3%), and gastric perforation and rectal tear (1%). Notably, 2.4% of patients with typhoid peritonitis, 3.0% with duodenal perforation, 3.5% with ruptured appendix, 14.2% with tuberculous intestine, 33.3% with tumour perforation, and 100% with liver abscess perforation passed. Paralytic ileus (8%) and burst abdomen (8%), were the most common complications. Conclusion: Typhoid ileal perforation was the major cause of peritonitis, and paralytic ileus and burst abdomen were the most common complications contributing to the mortality rate.
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Kumari, Archana, and Anubha Vidyarthi. "An analysis of relaparotomy in operative obstetrics." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (2020): 1813. http://dx.doi.org/10.18203/2320-1770.ijrcog20201560.
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Background: Relaparotomy in obstetrics following caesarean section or laparotomy is associated with high morbidity and mortality and hence, considered as maternal near miss. Selection of patient for the same is crucial. This study was done to know the incidence, indications, the risk factors, intraoperative procedures and mortality rates of relaparotomy.Methods: A retrospective analysis of relaparotomy after primary obstetric surgery over a period of two and half years (June 2016 to November 2018) was done in department of obstetrics and gynecology of Rajendra Institute of Medical Sciences, Ranchi, India.Results: During study period 28 cases of relaparotomy (18 inhouse and 10 referred cases) were identified. The incidence of relaparotomy was 0.24%. Intraperitoneal hemorrhage (39.2%) was commonest indication of reoperations followed by PPH (17.8%), rectus sheath hematoma (14.8%) and burst abdomen (10.7%). Obstructed labor (32.1%) was commonest indication of primary cesarean. Hysterectomy was required in 8 cases (25.7%), evacuation of blood for hemoperitoneum was required in another 8 cases. Most cases of hemorrhage were reopened within 24 hours, whereas most case of the rectus sheath hematoma, burst abdomen, and broad ligament hematoma were reopened between 5-9 days.Conclusions: Relaparotomy is often a lifesaving procedure. Decision to perform and manage relaparotomy should always be done by senior obstetricians. Meticulous surgical techniques to secure hemostasis at time of primary surgery should be adopted. Strict postoperative vigilance, is of utmost importance for early detection of intraperitoneal hemorrhage and other complications requiring relaparotomy as timely intervention.
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Poudel, Sandesh, Shree Prasad Adhikari, Snigdha Rai, Sangeeta Mishra, and Renuka Tamrakar. "Relaparotomy after Cesarean Section in a Tertiary Center." Europasian Journal of Medical Sciences 3, no. 1 (2021): 6–11. http://dx.doi.org/10.46405/ejms.v3i1.287.
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Background: Relaparotomy after cesarean section is associated with significant maternal morbidity and mortality which can be prevented with proper precaution during the primary surgery. The objective of the study was to determine factors associated with relaparotomy after cesarean section. 
 Methods: A hospital based descriptive cross sectional study conducted by analyzing the records of 3 years from 1st July 2017 to 30th June 2020, among the women who underwent relaparotomy after cesarean section at Paropakar Maternity and Women’s Hospital, Kathmandu.
 Results: There were 21,270 cesarean sections among 64,475 deliveries with the mean incidence of 32.6%. A total of 22 patients underwent relaparotomy out of which 18 had their primary surgery performed at our hospital i.e. 0.08% of the total caesarean section, and 4 cases were referred from peripheries. 60% of primary surgery were done by residents and the commonest indications of primary surgery were previous CS (36.3%) and obstructed labor (27.2%). Primary PPH was the major indication for laparotomy (31.8%) with mean interval from primary surgery of 4.7 hours followed by burst abdomen (22.7%) and secondary PPH (18.1%). Hysterectomy was the commonest operative intervention done during relaparotomy accounting for 45.4% followed by tension suture for burst abdomen (18%). There were 2 maternal death among them which were due to aspiration pneumonia following eclapmsia and DIC.
 Conclusion: Relaparotomy has increased risk of adverse maternal outcome but still is a lifesaving intervention. Early recognition, timely intervention and multidisciplinary teamwork helps to decrease the complications associated with it.
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Verma, Aruna, and Raghavi Maheshwari. "Postmenopausal spontaneous rupture of pyometra." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 4 (2022): 1313. http://dx.doi.org/10.18203/2320-1770.ijrcog20220927.
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Spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon, ranging from 0.01% to 0.5%. Herein, we report the case of a 55 year old postmenopausal woman, presented with acute abdominal pain, distended abdomen, and inability to pass flatus and feces, and purulent vaginal discharge. In view of generalized peritonitis, laparotomy was performed on which 3000 cc pus was suctioned out and necrotic tissue was found on the surface of liver and intestines. The uterus was found to have a 2×2 cm sized perforation at fundo-posterior surface from which purulent material was seen exuding. Thus, a diagnosis of perforated uterus due to pyometra was made. A total abdominal hysterectomy with bilateral salpingo-oophorectomy with thorough peritoneal lavage was done. Histopathological examination revealed perforated uterus with pyometra, but there was no evidence of malignancy, and the cervical canal was patent. The patient had burst abdomen on 6th postoperative day and subsequent resuturing was done. She was discharged on 17th postoperative day in satisfactory condition. Thus, rarely, perforation of uterus due to pyometra can cause peritonitis in postmenopausal females with signs of acute abdomen.