%0 Journal Article
%T Severe wound traction-blisters after inadequate dressing application following laparoscopic cholecystectomy: case report of a preventable complication
%A Abayomi L Sanusi
%J Patient Safety in Surgery
%D 2011
%I BioMed Central
%R 10.1186/1754-9493-5-4
%X Following laparoscopic cholecystectomy for symptomatic gallstone disease, a seventy eight year old healthy white male broke out in painful erythema on either side of his epigastric port site. Vesicles akin to a partial thickness burns were revealed upon removal of dressings. An unusual indentation created by the dressing, and skin traction by the dressing's adhesive edges were implicated, raising questions about technique of its application.Incorrect application of wound dressings can disrupt skin architecture, causing painful blistering. This complication should not occur to patients, as it is theoretically 100% preventable. Avoidance of stretching adhesive dressings, and careful adherence to relevant manufacturers' instructions are recommended.Postoperative peri-wound blistering is a well-recognized phenomenon in Orthopaedic, and to a lesser extent Gynaecological surgery. No cases have previously been reported following Laparoscopic surgery, where incisions are comparatively shorter. Despite a glaring dearth of literature on the topic, there is a recognized association with dressings. We report the first case of post laparoscopic cholecystectomy wound traction blistering, and suggest recommendations to avoid it.A 78-year-old healthy white male had an uneventful laparoscopic cholecystectomy for symptomatic gallstone disease. Within 24 hours he developed an area of painful erythema, with blistering and increased local heat on both sides of his epigastric port incision. An area akin to superficial dermal partial thickness burn was in contact with the adhesive lateral aspects of the dressing, where it was fixed to skin [Figure 1].It was observed that the central rectangular absorbent-pad part of the dressing had caused a well-demarcated indentation on the skin, although no pressure dressings had been applied [Figure 2]. Retrieval of his gallbladder (using a Bag for Endoscopic Retrieval of Tissue) had been via his umbilical port, which was not affected by the described
%U http://www.pssjournal.com/content/5/1/4