BURST ABDOMEN or WOUND DEHISCENCE

BURST ABDOMEN or wound dehiscence is a term used in surgery to denote a condition where after surgery the abdominal walls of a patient cannot hold the excess edematous fluid in the peritoneal cavity and separate at the incision site. That is, the muscles and the fascia that make up the abdominal wall give away to the increasing pressure inside the abdomen spilling its contents.Though a really terrifying condition for the onlookers it is a treatable condition unless complicated by other comorbid conditions like diabetes.
It occurs in 1-2% of the cases of operations on the abdomen mostly between the 6th and 8th day after the surgery.The factors relating to the incidence of burst abdomen are:
Choice of suture material-higher incidence with the use of catgut than with the use of non-absorbable monofilament
Method of closure-Interrupted suturing has a lower incidence than the continuous suturing
Drainage- drainage directly through a wound has a higher incidenceOperations on the pancreas have higher incidence:
Coughing,Vomiting and distension post operatively can lead to burst abdomen
Obesity, Jaudice, malignant disease ,hypoprotinemia and anaemia are also important risk factors

Clinical features:
serosanguinous (pink )coloured discharge is an important forerunner in 50%.Patient might complain of feeling of something giving way.

Treatment is an emergency operation to replace the bowel, relieve any obstruction and resuture the wound. A second incidence is rare.

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RABIES: A FATAL, BUT PREVENTABLE DISEASE

RABIES: A FATAL, BUT PREVENTABLE DISEASE

Rabies is practically a 100% fatal disease .There are only 4
recorded survivors till date who recovered following intensive life
support and excellent nursing care.

Points to Remember:
1.Rabies is 100% fatal.
2.Rabies is preventable through wound care, correct use of vaccines and sera.
3.Incorrect/wrong treatment to animal bite victims may lead to rabies death and litigation under Consumer Protection Act.
4.It is very important also to elicit information about the biting
animal (dog/cat).
5.Healthy, pet and regularly vaccinated dog / cat (low risk
category).
6.Healthy, pet and vaccination doubtful or not done
(moderate risk category).
7.Rabid, Sick, died, stray (dog/cat) or other animals or wild
animals (high risk category).

The signs of rabies in the dog/cat are:
–>Any change in its normal behaviour
suggesting either undue aggression
or depression.
—>Running aimlessly and attacking
others without any provocation.
—>Becomes too drowsy and withdraws
itself to a corner.
—>Excessive salivation.
—>Change in its voice/bark.
—>Refusal to feed or eating unusual objects like stone, paper, wood, metal pieces, etc.
—>Death of the animal.

“Do”
–.Wash all wounds under running water (or flushing) for atleast
10-15 minutes.
–>Gently clean all wounds with a detergent or any soap available (soaps are viricidal).
–>Apply any household antiseptic like Dettol, Savlon, and Povidone iodine (preferred).
–>In extraneous circumstances other alcoholic (>40%) preparations like Rum, Whisky, after-shave lotion may be
applied on the wound (s).

“Do not”
–>B a n d a g e o r d r e s s t h e w o u n d
(wherever practicable or as far as
possible).
–>Use tincture iodine.
–>Suture the wound.

“Discourage”
—>Not to apply any local applicants like turmeric, neem, red chilli, lime, plant juices, coffee powder, coin, etc. as these will act as irritants and propel the virus in the wound deeper t o c a u s e n e r v e i n f e c t i o n a n d resultant rabies encephalitis and
death.

KINDLY APPROACH NEAREST HOSPITAL and SAVE LIFE

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