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ABSTRACTS
PURPOSE OF STUDY: The aim of this study is to prove and evidence the effectiveness of our dressing methodical for surgical wounds and, contemporary, to quote the results obtained in our Thoracic Surgery Division.
METHODS: Between January 1987 to January 2001, a total of 2268 Patients underwent major thoracotomy. We exclude from The analysis the less thoracotomy, generally effected for bioptic operations on mediastinal masses, and the sternotomy. All this, for working on more possible homogeneous data. From 1987 to 1997 thoracotomic incision were 1482. We Performed backlateral and/or anterolateral or lateral thoracotomy with saving of rib. The backlateral accesses have always required the Great Dentato muscle’s section. Skin incision is made with blade for the subcutaneous. Muscolar and fascial plans are lanced with electric scalpel in coagulation formality. In this period muscular plans reconstructions have been performed with separate stitches in riabsorbable material ( Vycril ). The skin has been sutured with separate stitches in silk. Skin disinfection has been made with Betadine ( iodiopoidone at 10% ). Since 1987 skin synthesis is performed with metallic stitches. From 1997 we use a new transparent seal ( steridap ) as protection of the cutaneous working area. At the end, the injury is cleaned with with physiological and then covered with a sterile dressing. The not secretimg dressing is normally removed in post- operative second day. Wounds are daily medicated since post-operative second day. Dressing technical plans the clening with a volatile solution of ether or petrol. Then we use Eosina to ultimate the cleaning.
RESULT: Moreover always this method immediately makes evident the formation both of the local gathering with well- known swellings of margins and of the possible located secretions. Such operating method exposes the wound to the contact with the garment and the linen. Nevertheless the wound is protected by the colouring/disinfectant film. Between January 1987 to January 2002 we number 18 suppurated wounds ( 0.79% ) in accordance with such trend. Until 1997 suppurated wounds were 14 ( 0.94% ). From 1997 to 2002 the suppurations were 4 ( 0.51% ).
CONCLUSION: With the reduction of the muscular sacrifice and the cutaneous synthesis of the metallic material operated since 1997, the incidence of the suppurated wounds, however already low, is reduced. Our disinfectional technical consents low suppurative risk and allow a remarkable sparing of the consumption material and the dressing time. In spite of the fact that most part of the reference literature advises the protection of the post- operative wounds with dressing material, our data don’t demonstrate that to leave uncovered the injury from the second post-operative day caused any damage for the recovery.
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Potete
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