Causes

of a prolonged prothrombin time (PT) and/or a prolonged activated partial thromboplastin time (aPTT)

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Post OP Seroma & Incisional Hernia

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Post OP Seroma & Incisional Hernia

Incisional hernia remains a major problem (upto 20%) for the general surgeon. The causes are multiple and include
Obesity, Wound infections, Malnutrition, Technical wound closure factors

The high recurrence rate (25-50%) of incisional hernias after primary closure by tissue approximation led to the development of tension- free procedures using prosthetic materials. Common complications:
subcutaneous seroma wound infection Recurrence

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Post OP Seroma & Incisional Hernia

The recurrence rate for ventral, incisional hernia repair is 25% to 50% when primarily repaired. The placement of prosthetic biomaterials in the retrorectus, preperitoneal space to repair ventral, incisional hernias as popularized by Rives, Stoppa, and Wantz has reduced the recurrence rate to 14% to 32 In clinical studies, the most reliable adhesion-resistant prosthetic biomaterial for intra-abdominal placement during laparoscopic & open ventral hernia repair has been PTFE (Ann Surg 2003;238:391).
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SVR Hypovolemic shock.

Q: In a hypotensive patient in the intensive care unit, the finding most useful in the diagnosis of sepsis is a
A. CVP of 8 cms H2O B. Cardiac index of 2.5 L/min/m2 C. PH of 7.38 D. Systemic vascular resistance of 500 dynes.sec/cm. M2 E. Pulse rate of 120/min

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SVR Hypovolemic shock.

Answer: D. Unlike other forms of shock, patients with septic shock are normovolemic with reasonable filling pressures. The cardiac output is increased secondary to the hyperdynamic state induced by the sepsis. The peripheral resistance is low and produces the paradoxical warm shock with pink dry extremities. A low systemic vascular resistance is therefore most useful in establishing the diagnosis. Tachycardia is a nonspecific finding and does not suggest any specific etiology
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