Question

CASE STUDY 4 Dorothea just had her ruptured appendix removed. The skin and subetaneous layers of her wound b wodd been left open fier surgeon told her that if her wound showed no signs of infection in five days, he w finish the closure She will return to his office later for removal of her skin stitches at her postopenative 1. During the surgical procedure, the surgeon grasps the appendix for removal. The mesoappendix is clamoud with hemostats, incised, and a stick tie is used to prevent bleeding. He then asks for a suture. Why wpuid he use a purse-string stitch at the base of the appendix? 2 Why did the surgeon leave the wound partialy open and insert a penrose drain? In its present condision, by what method is the wound expected to heal? 3. When will the surgeon possibly close the wound? How will the surgeon determine if Dorothea's wourd may be closed in five days? 4. If the wound can be closed in five days, what type of healing will then be expected? What is the expected amount of tensile strength that can be regained? 5. As the surgeon works, he talks about Professor Halstead. What contributions did he make that are being applied to this situation?

Answer 1

1. Purse string sutures are continuous sutures applied around a circular opening which when pulled from both ends closes like a purse. This is done in appendix to bury the stump of the appendix to prevent leakage of the contents

2. The wound was left partially open for leaving a drain inside which would drain all the secretions that accumulate after the procedure. The wound at this stage would heal by primary intention

3. The surgeon will close the wound when there is no secretions collecting in the drain. He will check for the drainage contents which will probably stop by 5 days

4.if wound is closed in 5 days it heals by second intention, the tensile strength of the wound is increased

5. Professor Halted insisted and practised strict aseptic technique during surgical procedure