title: Post-thoracotomy wound separation (DEHISCENCE): a disturbing complication.
abstract: OBJECTIVE
  We described the treatment of dehiscence of thoracotomy incisions in patients who underwent thoracic surgery in the present study.
  
  
  METHODS
  Twenty-four patients with either partial or complete dehiscence of their thoracotomy incisions were included in the study from 2005 to 2010. The patients were evaluated regarding their age, sex, indication for thoracotomy, and surgical approaches. We also described our method of re-closure.
  
  
  RESULTS
  The male/female ratio was 17/7. The youngest and oldest patients were 15 and 75 years old, respectively, and the mean age was 43 years. Among the indications for thoracotomy, empyema was the most common reason (determined in eight [33%] patients), followed by vertebral surgery (determined in six [25%] patients). Bacterial growth was detected in the wound site cultures from 13 (54%) patients. For the patients with dehiscence of their thoracotomy incisions, an en block approximation technique with debridement was performed under general or local anesthesia in 16 (66%) and eight (33%) of the cases, respectively. Three patients exhibited an open thorax with dehiscence of the thoracotomy incision. Thoracoplasty was required in two patients. Using this method, successful closure was obtained in 91.7% (n = 22) of the patients with dehiscence of their thoracotomy incisions.
  
  
  CONCLUSIONS
  Dehiscence of the thoracotomy incision is an important complication that causes concern in patients and their thoracic surgeons and strongly affects the success of the surgery. An en block approximation technique with significant debridement that enables removal of the necrotic tissues from the wound site can successfully be applied to patients with dehiscence of their thoracotomy incisions.
authors: Cumhuriyet University, School of Medicine Sivas, Department of Thoracic Surgery, Sivas/Turkey. anadir@ttmail.com
authors: Aydin
authors: A
authors: Nadir
authors: Melih
authors: M
authors: Kaptanoglu
authors: Ekber
authors: E
authors: Sahin
authors: Hakan
authors: H
authors: Sarzep
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D012867:Skin / Q000473:pathology; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery; D013908:Thoracotomy / Q000009:adverse effects*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult