Choice of incision in surgical management of small bowel perforations in enteric fever.
Article
in English
| IMSEAR
| ID: sea-124709
ABSTRACT
Fifty six patients with typhoid enteric perforation who underwent operative treatment were randomly assigned to 2 groups. Twenty seven patients in group A underwent laparotomy via the Rutherford-Morrison incision while 29 patients in group B underwent the same procedure via a right paramedian incision. Surgical treatment consisted of two layer closure of the perforation with peritoneal lavage and tube drainage in all cases. Mean operating time in group A and group B was 45 +/- 10 minutes and 73 +/- 6 minutes respectively (p < 0.001). Postoperative wound dehiscence in group A and group B was observed in 2 and 11 cases respectively (p < 0.001). Incisional hernia developed in 8 patients in group B and none in group A (p < 0.01). Two patients in group A and 10 in group B developed adhesion-obstruction (p < 0.05). Differences in wound sepsis, pelvic abscess and mortality were not significant. Mean hospital stay in groups A and B was 12.4 days and 16.8 days respectively (p < 0.001). We conclude that in the presence of a confirmed preoperative diagnosis of typhoid enteric perforation, laparotomy via the Rutherford-Morrison incision may significantly reduce postoperative wound complications and morbidity without significantly altering the overall outcome.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Postoperative Complications
/
Typhoid Fever
/
Female
/
Humans
/
Male
/
Treatment Outcome
/
Intestinal Perforation
/
Laparotomy
Type of study:
Controlled clinical trial
Language:
English
Year:
1997
Type:
Article
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