General Surgery Experts Discuss Surgical Wound Infection

This case involves a middle-aged male patient in Wyoming who was morbidly obese patient who suffered from an infected surgical incision following surgery. The patient presented to a general surgeon for what was initially supposed to be a routine gallbladder removal surgery performed with a traditional incision. The surgery proceeded without complications and the patient was discharged home. However, less than a week after the surgery was completed the patient returned to the hospital to have his stitches removed at which point the wound completely opened. Over the next few days, the wound became infected. The patient was forced to endure an extended stay in the hospital, and was left seriously disfigured.

Question(s) For Expert Witness

1. Do you routinely perform this procedure?

2. Do you frequently leave staples in longer than one week for such a procedure?

Expert Witness Response E-008057

I routinely perform this procedure, on average 1 to 2 cases per week. Closures on the abdomen should be left in on average 10 to 14 days, and a vigilant eye should be kept on the patient's progress in order to identify the development of infection. I have significant experience in both open and laparoscopic cholecystectomy. In addition, I have fellowship training in bariatric surgery dealing with patients like the one described here with morbid obesity. I am an assistant professor of surgery at a major teaching university hospital focusing on upper GI and general surgery. I am also an associate program director for the general surgery residency.