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[The current problems of relaparotomy]
Abstract:
Relaparotomy was performed in 252 of 23,232 (1.08%) patients operated upon. The most frequent cause of relaparotomy is purulent complications. These patients have immunodeficient states due to different causes (duration of the disease, old age, diabetes mellitus, toxemia, anemia, extension of the injuries, irrational administration of antibiotics). Due to it, anaerobic neclostridial infection is widely used. Its participation in the purulent process in the abdominal cavity achieves 80-90%. For prevention and treatment of purulent complications of great importance is the modern and adequate struggle against intoxication and hypoxia, correction of immunodepression, purposeful antimicrobial therapy. Problems in determination of indications for relaparotomy are emphasized and the necessity to perform it in earlier terms.
Insights
Relaparotomy, often caused by purulent complications, affects 1.08% of surgical patients. Addressing immunodeficiency and anaerobic infections is crucial for better outcomes.
Area of Science:
- Surgical complications
- Infectious disease
Context:
- Relaparotomy (re-operation of the abdomen) was performed in 252 out of 23,232 patients (1.08%) undergoing surgery.
- Purulent complications are the most frequent indication for relaparotomy.
Purpose:
- To highlight the causes and implications of relaparotomy.
- To emphasize the role of anaerobic infections in abdominal purulent processes.
- To underscore the importance of managing intoxication, hypoxia, and immunodepression.
Summary:
- Patients undergoing relaparotomy often present with immunodeficient states linked to various factors like disease duration, age, diabetes, anemia, and antibiotic misuse.
- Anaerobic neclostridial infection is prevalent, contributing significantly (80-90%) to intra-abdominal purulent processes.
- Effective prevention and treatment necessitate managing intoxication, hypoxia, correcting immunodepression, and employing targeted antimicrobial therapy.
Impact:
- Highlights challenges in determining indications for relaparotomy.
- Stresses the need for earlier surgical intervention in relaparotomy cases.
- Informs strategies for reducing morbidity and mortality associated with surgical site infections.