KNH 411: Case Study #29 Understanding the Disease and Pathophysiology The patient has suffered a gunshot to the abdomen. This has resulted in an open abdomen. Define open abdomen. The medical record describes the use of a wound Describe this procedure and its connection to the diagnosis for open “VAC.” abdomen. Open abdomen is a strategy used for the management of abdominal emergencies in both traumatic and general surgery situations. The abdominal wall is left open as the result of an injury, because of concern for abdominal compartment syndrome, or because of a significant injury that has produced significant soft tissue defects. A wound VAC promotes wound healing by delivering negative pressure (a vacuum) to the wound site through a dressing. This pressure helps draw the wound edges together, remove infection, and promote the formation of new connective tissue. This system would be ideal to carefully heal and promote the closure of open abdomen. The abdominal tissue would be provided with a unique environment for healing with the removal of infectious materials, reduction of edema, and formulation of new tissues. The patient underwent gastric resection and repair, control of liver hemorrhage, and resection of proximal jejunum, leaving his GI tract in discontinuity. Describe the potential effects of surgery on this patient’s ability to meet his nutritional needs. The metabolic stress response to trauma has been described as a progression through three phases: the ebb phase, the flow phase, and finally the recovery or resolution. Define each of these and determine how they may correspond to this patient’s hospital course. The ebb phase defines the period of time immediately after the injury—2-48 hours. This time period is characterized by shock resulting in hypovolemia and decreased oxygen
KNH 411: Case Study #29 Understanding the Disease and Pathophysiology The patient has suffered a gunshot to the abdomen. This has resulted in an open abdomen. Define open abdomen. The medical record describes the use of a wound “VAC.” Describe this procedure and its connection to the diagnosis for open abdomen. Open abdomen is a strategy used for the management of abdominal emergencies in both traumatic and general surgery situations. The abdominal wall is left open as the result of an injury, because of concern for abdominal compartment syndrome, or because of a significant injury that has produced significant soft tissue defects. A wound VAC promotes wound healing by delivering negative pressure (a vacuum) to the wound site through a dressing. This pressure helps draw the wound edges together, remove infection, and promote the formation of new connective tissue. This system would be ideal to carefully heal and promote the closure of open abdomen. The abdominal tissue would be provided with a unique environment for healing with the removal of infectious materials, reduction of edema, and formulation of new tissues. The patient underwent gastric resection and repair, control of liver hemorrhage, and resection of proximal jejunum, leaving his GI tract in discontinuity. Describe the potential effects of surgery on this patient’s ability to meet his nutritional needs. The metabolic stress response to trauma has been described as a progression through three phases: the ebb phase, the flow phase, and finally the recovery or resolution. Define each of these and determine how they may correspond to this patient’s hospital course. The ebb phase defines the period of time immediately after the injury—2-48 hours. This time period is characterized by shock resulting in hypovolemia and decreased oxygen
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