Prevention of Entero-Atmospheric Fistula: The Initial Closure of the Abdomen.

Abdominal Compartment Syndrome closure of open abdomen entero-atmospheric fistulae meshes in open abdomen open abdomen skin grafts in open abdomen

Journal

Hellenike cheirourgike. Acta chirurgica Hellenica
ISSN: 0018-0092
Titre abrégé: Hell Cheirourgike
Pays: Austria
ID NLM: 17330220R

Informations de publication

Date de publication:
2020
Historique:
received: 26 08 2020
accepted: 02 09 2020
entrez: 29 3 2021
pubmed: 1 1 2020
medline: 1 1 2020
Statut: ppublish

Résumé

The "Open Abdomen" technique for difficult conditions such as trauma, necrotizing pancreatitis, severe peritonitis, reoperations and transplantations have become a very useful way to save patients. The more severe complication of this method are the enteroatmospheric fistulae with a frequency of 5-75% and a mortality up to 42%. So any effort to prevent these is very essential. The aim of this paper is to present methods of the initial (temporary) closure of the abdomen for the prevention of this catastrophe, when early approximation of the abdominal wall is not feasible. We present two representative case reports and we describe the use of full thickness or split skin grafts as first step for abdominal closure. The outcome of our patients by using tissues for temporary abdominal closure seems to have fewer problems than other methods with synthetic materials. We think that this is a reasonable option for the cases where we cannot achieve approximation of the abdominal wall edges in the early days of an open abdomen.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
The "Open Abdomen" technique for difficult conditions such as trauma, necrotizing pancreatitis, severe peritonitis, reoperations and transplantations have become a very useful way to save patients. The more severe complication of this method are the enteroatmospheric fistulae with a frequency of 5-75% and a mortality up to 42%. So any effort to prevent these is very essential. The aim of this paper is to present methods of the initial (temporary) closure of the abdomen for the prevention of this catastrophe, when early approximation of the abdominal wall is not feasible.
METHODS AND MATERIALS METHODS
We present two representative case reports and we describe the use of full thickness or split skin grafts as first step for abdominal closure.
RESULTS AND CONCLUSIONS CONCLUSIONS
The outcome of our patients by using tissues for temporary abdominal closure seems to have fewer problems than other methods with synthetic materials. We think that this is a reasonable option for the cases where we cannot achieve approximation of the abdominal wall edges in the early days of an open abdomen.

Identifiants

pubmed: 33776078
doi: 10.1007/s13126-020-0580-5
pii: 580
pmc: PMC7982305
doi:

Types de publication

Journal Article

Langues

eng

Pagination

208-210

Informations de copyright

© Hellenic Surgical Society 2020.

Références

J Trauma. 2003 Nov;55(5):999-1001
pubmed: 14608185
Am Surg. 2009 Nov;75(11 Suppl):S1-22
pubmed: 19998714
Scand J Surg. 2013;102(2):61-8
pubmed: 23820678
Surg Clin North Am. 1997 Aug;77(4):783-800
pubmed: 9291981

Auteurs

Dionysios Voros (D)

3rd Department of Surgery, Henry Dunant Hospital Center, Athens, Greece.

G Anastasopoulos (G)

3rd Department of Surgery, Henry Dunant Hospital Center, Athens, Greece.

G Sarris (G)

3rd Department of Surgery, Henry Dunant Hospital Center, Athens, Greece.

A Fotopoulos (A)

1st Department of Surgery, Sismanoglion Hospital of Athens, Athens, Greece.

A Marinis (A)

1st Department of Surgery, Tzaneion Hospital of Piraeus, Piraeus, Greece.

K Dougli (K)

Department Plastic Surgery, General Hospital of Athens, Athens, Greece.

Classifications MeSH