Reoperative Surgery in Acute Setting: When To Go Back?
The return to the operating room in the perioperative settings, or in the acute settings, has not been defined well, despite the fact that it happens often, although the exact frequency how often we take the patient back is not known. The reason why we need to bring the patient back to the operating room can be divided into planned and unplanned procedures. The unplanned procedures can be classified further into acute (mostly due to bleeding, such as tamponade following CABG or any other major surgery), major infection or some other sort of wound catastrophe (dehiscence), intestinal obstruction or anastomotic leak that may become evident perioperatively. The planned return to the operating room has been described a bit better (second look laparotomy for example, damage control as described in Chap. 10, and planned laparotomy for the management of major intraperitoneal infection). In this chapter we will attempt to address, mainly, unplanned laparotomy and decision-making process, but we will also analyze the planned return to the operating room.
KeywordsPlanned return to the operating room Reoperation Acute wound dehiscence
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