Question

you are scrubbed in a trauma case, and the surgeon has spent several hours controlling bleeding and closing major abdominal wounds. The patient is now stable, and you expect the surgeon to turn his attention to a leg wound. Instead, he leaves the wound u sutured and asks for your help in packing it. why would the surgeon decide not to close this wound?

Answer 1

The abdominal is the area where fecal material and urine stored and it is contaminated part of the body. Patient came to the hospital after a trauma. Then He underwent a surgery for closing major abdominal wounds and controls his bleeding. Principles of procedure is clean from center to periphery and non contaminated area to contaminated area, but surgeon has done surgery in non-contaminated area because of massive bleeding and major abdominal wound that endanger patient patients life. Leg wound is not critical one and not going to affect patient life.

If the patient’s life is not critical, immediate surgery will be delayed until access of peritoneal lavage report. If the peritoneal lavage report shows positive bacteria and infected content, higher amount of Red blood cells, more white blood cell than normal, immediate surgery will be performed. If peritoneal lavage report shows negative for bacteria, amylase, white blood cell count more than 500/µl , red blood cell count more than 100,000/µl.

So the surgeon has take good decision and advised to close the leg wound with pack. Otherwise, there will be chances of septicemia, osteomyelitis if procedure of leg wound along with abdominal wound takes place.