Early Aggressive Closure of the Open Abdomen
| Autor: | Kenneth L. Mattox, Kathleen R. Liscum, Asher Hirshberg, Matthew J. Wall, Matthew M. Carrick, Hoang Q. Pham, Thomas S. Granchi, Bradford G. Scott, Francis J. Welsh |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Fistula Biocompatible Materials Wounds Penetrating Abdominal Injuries Critical Care and Intensive Care Medicine Prosthesis Implantation Abdominal wall medicine Humans Hernia Closure (psychology) Open abdomen Aged Retrospective Studies business.industry Abdominal Wall Suture Techniques technology industry and agriculture Retrospective cohort study Middle Aged medicine.disease Surgery body regions Treatment Outcome medicine.anatomical_structure Abdomen Female Collagen Complication business Algorithms |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 60:17-22 |
| ISSN: | 0022-5282 |
| DOI: | 10.1097/01.ta.0000200861.96568.bb |
| Popis: | The aim of this series is to describe a new and aggressive approach to definitive closure of the open abdomen.A retrospective review of 37 patients who underwent definitive abdominal closure using a combination of vacuum pack, vacuum-assisted wound management and human acellular dermal matrix (HADM).All patients' open abdomens were maintained with vacuum assisted wound management in attempts for primary closure. Once it was determined that the abdomen would not close primarily; it was closed with HADM and skin advancement. The mean duration of the open abdomen was 21.7 days (range 6-45), with an average of 127.78 cm of HADM, the largest number being 800 cm, with decreasing use of product later in the series. No major complications were seen with the repair. Superficial wound infection occurred with two patients that were easily treated with wet to dry dressing changes. No intraabdominal complications such as fistula or graft loss were seen. All patients left the hospital with an intact abdominal wall and skin. All 37 patients survived to discharge and were seen in follow-up within one month. No early hernia formation was seen at the one month follow up with the longest at three years. No abdominal wall complications were seen in subsequent follow up patients.Early aggressive closure of the open abdomen is possible with a combination of vacuum pack, vacuum-assisted wound management and HADM. Short term results are promising and warrant further study. |
| Databáze: | OpenAIRE |
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