Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXX: Reoperative Abdominal Surgery
United States Department of Defense
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The drainage of abscesses accounts for the greatest number of reoperations in abdominal wounds. When this complication presents relatively early in the postinjury period, it is most often associated with other complications, such as stress bleeding, fistula formation, and intestinal obstruction. Abscesses may also be chronic and present much later, with low-grade fever and inanition.
Treatment involves evacuation of the abscess, collapse of the cavity, and prevention of recurrence. Closedsuction drains help to achieve these objectives. If the cavity is not well formed, irrigation may disseminate organisms to other intraperitoneal sites. Judgment, therefore, must be exercised regarding the use and volume of irrigating solutions. Drains should be dependently positioned to achieve the maximum effect of gravity.
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