Fuente-Lira M, Mendoza MVH, Robledo-Ogazón F, Mier DJ, Martínez-Ordaz JL, Blanco-Benavides R

Language: Spanish
References: 28
Page: 157-163
PDF size: 122.41 Kb.

ABSTRACT

Background: The closing of a surgical wound in the abdominal wall must be reliable and leave the wall as hard as it was it before surgery. Immediate, tension-free can be impractical in patients with important loss of abdominal wall tissue by trauma, infections tissue approximation exacting radical resection of abdominal wall, intense visceral edema, retro-peritoneal hematoma, packing of the peritoneal cavity, planned multiple surgery for abdominal sepsis, uncertain intestinal viability, or damage-control surgical procedures. Objective: To demonstrate a new surgical technique for closing the abdominal wall using a polyethylene pouch. Method: From March 1998 to December 2000, abdominal wall closure with polyethylene pouch in 46 patient candidates for multiple surgery, loss of abdominal wall, serious abdominal sepsis, abdominal compartment syndrome, and other causes that prevented primary abdominal wall closure. Demographic data, previous surgeries, procedures carried out and their evolution, morbidity, mortality and evolution were obtained. Results: During this period, the procedure done in 46 patients, 28 men and 18 women, average age 53.6 years, number of procedures per patient ranged from 2 to 17; we observed 21.6% morbidity and 34.7% mortality not attributable to surgical technique. This polyethylene-pouch technique is a form simple closure and is efective in multiple abdominal surgeries, diminishes damage to intestinal integrity, and in some cases the need for reintervention.

REFERENCES

1. Ellis H. Incisions, closure, and management of the wound. In: Zinner MJ, Schwartz SI, Ellis H editors. Maingot’s abdominal operations, 10 EDT. Appleton & Lange; 1997.395-405.

2. Cohen IK, Diegelmann RF, Crossland MC. Cuidado y cicatrización de heridas. En: Schwartz SI, Shires A et al, editors. Principios de cirugía. 6th ed. México: Interamericana; 1995.288.

3. Barker DE, Kaufman HJ et al. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma 2000;48:201-207.

4. Brock WB, Barker DE, Burns RP. Temporary closure of open abdominal wounds: the vacuum pack. Am surg 1995;61:30-35.

5. Fansler R, Taheri P et al. Polypropylene mesh closure of the complicated abdominal wound. Am J Surg 1995;170:15-18.

6. Kron IC, Harman KP, Nolan PN. The measurement of intra-abdominal pressure as criterion for abdominal re-exploration. Ann Surg 1984;199:28-30.

7. Smith LA, Barker DE et al. Vacuum pack technique of temporary abdominal closure: a four-year experience. Am Surg 1997;63:1102-1108.

8. Howdieshell TR, Yeh KA et al. Temporary abdominal wall closure in trauma patients: indications, technique, and results. World J Surg 1995;19:154-158.

9. Schein M, Decker GAG. Gastrointestinal fistulas associated with large abdominal wall defects: experience with 43 patients. Br J Surg 1990;77:97-100.

10. Wittmann DH, Aprahamian C et al. A burr-like device to facilitate temporary abdominal closure in planned multiple laparotomies. Eur J Surg 1993;159:75-79.

11. Schein M, Hirshberg A, Hashmanai M. Current surgical management of severe intraabdominal infection. Surgery 1992;112:489-496.

12. Mughal MM, Bancewicz J, Irving MH. “Laparostomy”: a technique for the management of intractable intra-abdominal sepsis. Br J Surg 1986;73:253-259.

13. Mayberry JC. Bedside open abdominal surgery: utility and wound management. Critical Care Clin 2000;16:151-172.

14. Rotondo MF, Schwab W, McGonigal MD et al. “Damage control”: an approach for improved survival in penetrating abdominal injury. J Trauma 1993;35:375-382.

15. Fernández L, Norwood S et al. Temporary intravenous bag silo closure in severe abdominal trauma. J Trauma 1996;40:258-260.

16. Schein M, Saadia R, Jamieson JR, Decker GAG. The “sandwich technique” in the management of the open abdomen. Br J Surg 1986;73: 369-370.

17. Hannon RJ, Hood JM, Curry RC. Temporary abdominal closure: a new product. Br J Surg 1992;79:820-821.

18. Voyles CR, Richardson JD, Bland KI et al. Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefist versus long-term complications. Ann Surg 1981;194:219-223.

19. Edit JE, Broadwater JR, Barone GW. A simplified temporary abdominal closure with latex rubber and marlex mesh. J Am Coll Surg 1994;178:513-515.

20. Sherck J, Seiver A et al. Covering the “open abdomen”: a better technique. Am Surg 1998;64:854-857.

21. Ghimenton F, Thomson SR, Muckart DJJ, Burrows R. Abdominal content containment: practicalities and outcome. Br J Surg 2000; 87:106-109.

22. Ciresi DL, Cali RF, Senagore AJ. Abdominal closure using nonabsorbable mesh after massive resuscitation prevents abdominal compartments syndrome and gastrointestinal fistula. Am Surg 1999;65: 720-725.

23. Nagy KK, Fildes JJ, Mahr C et al. Experience with three prosthetic materials in temporary abdominal wall closure. Am Surg 1996;62: 331-335.

24. Mayberry JC, Mullins RJ, Crass RA, Trunkey DD. Prevention of abdominal compartment syndrome by absorbable mesh prosthesis closure. Arch Surg 1997;132:957-962.

25. Fransler RF, Taheri P, Culinane C et al. Polypropylene mesh closure of the complicated abdominal wound. Am J Surg 1995;170: 15-18.

26. Mizrahi S, Deutsch M et al. Improved zipper closure of the abdominal wall in patients requiring multiple intra-abdominal operations. Am J Surg 1993;166:62-63.

27. Hakkiluoto A, Hannukainen J. Open management with mesh and zipper of patients with intra-abdominal abscesses of diffuse peritonitis. Eur J Surg 1992;158:403-405.

28. Walsh GL, Chiasson P et al. The open abdomen. The marlex mesh and zipper technique: a method of managing intraperitoneal infection. Surg Clin North Am 1988;68:25-40.