University of Pardubice Faculty of Health Studies

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Surgical wound decompresion in a patient after total laryngectomy.

Authors: Mejzlík Jan | Pellant Arnošt | Chrobok Viktor

Type of publication: konference, workshop, výstava

Page from-to: nestránkováno

Titles:

Language	Name	Abstract	Keywords
cze	Dekomprese rány u nemocného po totální larygektomii.	Po totální larygektomii při příliš těsném utažení obvazu hrozí riziko tkáňové ischemie. Autoři uvádějí případ dekomprese rány provedené přestřižením obvazu a zabývají se vlivem změny tlaku ve tkáních a hojením rány.
eng	Surgical wound decompresion in a patient after total laryngectomy.	INTRODUCCTION: The wide range of different factors influences surgical wound healing in patients after total laryngectomies. The state of capillary microcirculation is one of them. The wound swelling is one of the results of common patho-physiological process developing after the surgery. Moderate tissular pressure increase is ordinary. If the interstitial pressure exceeds mean capillary pressure, the tissular ischemia can develop with all subsequence. OBJECTIVES The goal of the study is to describe the effect of surgical wound decompression using a bandage slit on tissular pressure and the outcome and benefit of patients undergoing this procedure. METHODS Twelve patients who underwent surgery for extensive primary carcinomas of the larynx (12 times total laryngectomy), and with regional node metastases, (9 times unilateral and 3 times bilateral block dissection) had during a reconstruction of their neck tissues a silicone microchip (Codman? ICP MicroSensorTM ) implanted into a suitable location under a muscle layer. During 48 hours following surgery a continuous monitoring of pressure in selected tissue boundaries was performed, together with other laboratory values. RESULTS In one patient at the beginning of the study who?s the tissular pressure exceeded 15 Torr the prolonged wound healing followed. This event was the reason of the surgical wound decompression in another 3 people when the tissular pressure approached 15Torr. Transiently pressure decreased twice and elevated again after the decompression with the prolonged healing. Only one permanent pressure reduction and the good healing were observed. CONCLUSIONS Surgical wound decompression of the neck is the only available treatment for tissular hypertension after extensive neck surgery, and this method has not been reported yet. Patients who require decompression are a selected group of the total study file. Also, most papers focus on factors associated with tissular hypertension and its effe	Compartment Syndrome;Neck Surgery;Microcirculation