On the other hand, these extended surgical procedures increase the www.selleckchem.com/products/BIBF1120.html risk of postoperative complications. Although rare, evisceration occurred on the postoperative day 5 in this patient and emergency intervention in the operating theatre followed. Evisceration may occur at any time from the original wound closure to postoperative day 21. Most eviscerations occur on postoperative day 7. The initial bedside management should be aimed at stabilization of the patient and preparation for a return to the operating room. When evisceration is evident, the abdominal contents should be carefully and gently replaced by using a sterile technique. The wound should be covered with a sterile dressing moistened with warm saline. Cultures should be taken and the patient administered prophylactic antibiotics.

The successful management of evisceration depends on attention paid to long-standing surgical principles: careful dissection, appropriate choice of materials and techniques, closure without tension and meticulous postoperative care (15). Additionally, synchronous treatment of hypoproteinemia and anemia that often complicate cases of evisceration is necessary in order to avoid the high risk of morbidity and mortality. It is generally believed that the severity of the general condition of the patient plays the more important role in the outcome (16). Rodriguez-Hermosa et. al. (17) reported in a study of 12.622 patients who underwent laparotomy, 57 eviscerations (0.45%). Emergency surgery was performed in 48 patients and postoperative complications such as wound infection and paralytic ileus were present in the vast majority of the cases.

Laboratory investigations revealed leukocytosis, hypoproteinemia and anemia. High percentage of the patients (45.6%) required admission to the intensive care unit, while the mean length of hospital stay was 28.5 days. The overall lethality in this study ranged-up to 28%. In general, up to 3% of laparotomy incisions are associated with dehiscence, with or without evisceration, and more than half of repaired laparotomy dehiscences will go on to form incisional hernias, entering many patients into a cycle of surgical repair, reherniation, and acute and chronic wound complications (18). Postoperative wound dehiscence is associated with an additional 9 days of hospitalization, often in the intensive care unit, $40.

000 in excess charges, and 10% in-hospital attributable mortality (19). The best treatment for evisceration remains prevention. Even after the most successful and technically exquisite surgical procedure, due diligence must be paid to the closure of the incision.
A 67-year-old male hypertensive patient, height 160 cm and body weight 95 kg (body mass index 37.1 kg/m2, second Entinostat degree of abdominal obesity), underwent coronary artery bypass grafting under cardiopulmonary bypass.