Pediatric vacuum packing wound closure for damage-control laparotomy.

Autor: Markley MA; Section of Pediatric Surgery, Department of Surgery, The University of Oklahoma College of Medicine, Oklahoma City, OK, USA., Mantor PC, Letton RW, Tuggle DW
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2002 Mar; Vol. 37 (3), pp. 512-4.
DOI: 10.1053/jpsu.2002.30865
Abstrakt: Background/purpose: Recent studies advocate the use of the open-abdomen technique for managing the abdominal compartment syndrome and uncontrolled intraperitoneal sepsis. The authors have used vacuum packing (Vac-Pac) in pediatric patients with excellent results and have developed a method for closing widely distracted fascial edges to avoid the need for skin grafting.
Methods: Patients who had an intraabdominal catastrophe best managed by a temporary open-abdomen technique were included. After damage control laparotomy, the Vac-Pac temporary closure was used. In 2 patients a corsetlike lacing was used to bring the widely separated fascial edges together gradually.
Results: Five patients with intraabdominal sepsis and one with the abdominal compartment syndrome were included. The length of time the Vac-Pac was used ranged from 3 to 21 days. In 2 patients, the corset closure allowed wound approximation within 5 to 7 days. One patient died of overwhelming sepsis, the remainder of the patients survived.
Conclusions: The Vac-Pac technique for abdominal closure is a simple and inexpensive means by which to manage the open abdomen in the pediatric patient effectively. Use of a corset-type closure for wounds with widely distracted edges should eliminate the need for skin grafting over an open abdomen.
(Copyright 2002 by W.B. Saunders Company.)
Databáze: MEDLINE
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