265 results match your criteria Temporary Abdominal Closure Techniques


Open abdomen technique used in complications of major gynecological oncology surgery.

J Obstet Gynaecol Res 2022 Jul 20;48(7):1904-1912. Epub 2022 May 20.

Department of Gynecologic Oncology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Objective: To evaluate the open abdomen technique (laparostomy) used in complications of major gynecological oncology surgery.

Methods: We analyzed retrospectively the surgical database of all patients who had undergone major open surgery by the same gynecologic oncologist over a 5-year period. All patients who had had open abdomen procedure were identified; demographic data and indications of primary surgery, temporary abdominal closure procedure details, fascia closure and morbidity, mortality rates were evaluated. Read More

View Article and Full-Text PDF

An Alternative Abdominal Closure Technique After Pediatric Liver Transplant: Bogota Bag Technique.

Exp Clin Transplant 2022 05;20(Suppl 3):53-55

From the Baskent University, Department of General Surgery, Division of Transplantation, Ankara, Turkey.

Objectives: In conditions such as large-for-size syndrome, postreperfusion hepatic edema, and intestinal edema, primary closure of the abdominal wall can cause respiratory complications and thrombosis of vascular structures. Here, we compared results of primary abdominal closure versus a temporary patch closure technique (the Bogota bag technique) in pediatric liver transplant recipients.

Materials And Methods: We performed primary abdominal closure in 295 recipients. Read More

View Article and Full-Text PDF

Negative pressure wound therapy for managing the open abdomen in non-trauma patients.

Cochrane Database Syst Rev 2022 05 6;5:CD013710. Epub 2022 May 6.

Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Background: Management of the open abdomen is a considerable burden for patients and healthcare professionals. Various temporary abdominal closure techniques have been suggested for managing the open abdomen. In recent years, negative pressure wound therapy (NPWT) has been used in some centres for the treatment of non-trauma patients with an open abdomen; however, its effectiveness is uncertain. Read More

View Article and Full-Text PDF

Abdominal Negative Pressure Wound Therapy Devices for Management of the Open Abdomen: A Technologic Analysis.

Authors:
Carolyn Crumley

J Wound Ostomy Continence Nurs 2022 Mar-Apr 01;49(2):124-127

Carolyn Crumley, DNP, RN, ACNS-BC, CWOCN, Saint Luke's East Hospital, Lee's Summit, Missouri; University of Missouri Sinclair School of Nursing, Columbia, Missouri; and Section Editor JWOCN Evidence-Based Report Card.

Purpose: The purpose of this technologic analysis was to analyze technologic features of abdominal negative pressure wound therapy (NPWT).

Approach: Published literature regarding abdominal negative pressure wound therapy (aNPWT) devices was reviewed. A summary of management approaches for the open abdomen provides a foundation for understanding the benefits of aNPWT. Read More

View Article and Full-Text PDF

[Strategies for open abdomen].

Ugeskr Laeger 2022 01;184(4)

Afdelingen for Mave-, Tarm- og Leverlidelser, Københavns Universitetshospital - Herlev Hospital.

This is a review of temporary abdominal closure (TAC) strategies are necessary in cases where definitive surgery is not possible. Indications for TAC include damage control due to unstable physiology, the need for a second look, or lacking technical possibility for fascial closure. The superior method of TAC is vacuum-assisted closure (VAC), with or without a traction mesh. Read More

View Article and Full-Text PDF
January 2022

The Management of the Open Abdomen - A Literature Review.

Chirurgia (Bucur) 2021 Dec;116(6):645-656

An essential component of the concept of "Damage control surgery", laparostomy is the procedure by which the abdomen is deliberately abandoned open, the visceroperitoneal contents being temporarily protected by multiple technical means. Actual classification: Grade 1, without viscero-parietal adhesions or fixity of the abdominal wall (lateralization), divided into: 1A clean, 1B contaminated and 1C enteral fistula -cutaneous skin is considered clean); Grade 2, which develops fixation is subdivided into: 2A clean, 2B contaminated and 2C enteral fistula; Grade 3, "frozen abdomen", is divided into: 3A clean and 3B contaminated; Grade 4, defined as enteroatmospheric fistula, is a permanent fistula associated with the presence of granulation tissue and a frozen abdomen. Indications of the open abdomen are: damage control surgery, abdominal compartment syndrome, peritonitis, severe acute pancreatitis, vascular emergencies. Read More

View Article and Full-Text PDF
December 2021

Abdominal and thoracic wall closure: damage control surgery's cinderella.

Colomb Med (Cali) 2021 Apr-Jun;52(2):e4144777. Epub 2021 Jun 30.

Fundación Valle del Lili. Department of Surgery. Division of Trauma and Acute Care Surgery, Cali, Colombia.

Damage control surgery principles allow delayed management of traumatic lesions and early metabolic resuscitation by performing abbreviated procedures and prompt resuscitation maneuvers in severely injured trauma patients. However, the initial physiological response to trauma and surgery, along with the hemostatic resuscitation efforts, causes important side effects on intracavitary organs such as tissue edema, increased cavity pressure, and hemodynamic collapse. Consequently, different techniques have been developed over the years for a delayed cavity closure. Read More

View Article and Full-Text PDF
December 2021

Managing the Open Abdomen in Damage Control Surgery: Should Skin-Only Closure be Abandoned?

Cureus 2021 Jun 7;13(6):e15489. Epub 2021 Jun 7.

Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO.

During damage control laparotomy, surgery is abbreviated to allow for the correction of physiologic disturbances, with a plan to return to the operating theatre for definitive surgical repair. Re-entry into the abdomen is facilitated by temporary abdominal closure (TAC). Skin-only closure is one of the many techniques described for TAC Numerous sources advise against the use of this technique because of the risk of complications. Read More

View Article and Full-Text PDF

Age is But a Number: Damage Control Surgery Outcomes in Geriatric Emergency General Surgery.

J Surg Res 2021 11 6;267:452-457. Epub 2021 Jul 6.

St. Luke's University Health Network, Bethlehem, Pennsylvania. Electronic address:

Background: Damage control surgery (DCS) with temporary abdominal closure (TAC) is increasingly utilized in emergency general surgery (EGS). As the population ages, more geriatric patients (GP) are undergoing EGS operations. Concern exists for GP's ability to tolerate DCS. Read More

View Article and Full-Text PDF
November 2021

Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases.

Cureus 2021 Mar 23;13(3):e14066. Epub 2021 Mar 23.

General Surgery, Fiona Stanley and Fremantle Hospital Group, Perth, AUS.

Background Obtaining primary fascial closure following laparostomy can be difficult; especially with fascial retraction or large pre-existing fascial defects. Various techniques have been described in the literature which attempt to improve reapproximation rates. Most techniques described comprise the use of adjuncts including Bogota Bags, negative pressure dressings, anchor devices and various types of mesh. Read More

View Article and Full-Text PDF

Should Negative Pressure Therapy Replace Any Other Temporary Abdominal Closure Device in Open-Abdomen Management of Secondary Peritonitis?

Surg Technol Int 2021 05;38:127-138

Division for Endocrine and Minimally Invasive Surgery of the University of Messina, Italy.

Aim: To clarify the advantages of negative pressure therapy (NPT) compared to other methods of temporary abdominal closure (TAC) in the management of secondary peritonitis.

Methods: We retraced the history of known methods of TAC, and analyzed their advantages and disadvantages. We evaluated as the NPT mechanisms, both from the macroscopic that bio-molecular point of view, well suits to manage this difficult condition. Read More

View Article and Full-Text PDF

Skin-only closure as a temporary abdominal closure technique in a rural setting - exploring role and safety profile.

S Afr J Surg 2021 Mar;59(1):20-24

Ngwelezane General Hospital, South Africa and Department of Surgery, University of KwaZulu-Natal, South Africa.

Background: Acute laparotomy for trauma or sepsis often prevents definitive closure due to need for relook laparotomy or to prevent abdominal compartment syndrome. Skin-only closure is widely used in our setting. In this study, we review the safety and effectiveness of this technique. Read More

View Article and Full-Text PDF

Standard Urine Collection Bag as an Improvised Bogotá Bag as a Temporary Abdominal Closure Method in an Open Abdomen in Preventing Abdominal Compartment Syndrome.

Case Rep Surg 2021 29;2021:6689000. Epub 2021 Jan 29.

Department of General Surgery, Kilimanjaro Christian Medical University College (KCMUCo), P.O. Box 2240 Moshi, Tanzania.

Primary abdominal wall closure post laparotomy is not always possible. Certain surgical pathologies such as degloving anterior abdominal wall trauma injuries and peritoneal visceral volume and cavity disproportion render it nearly impossible for the attending surgeon to close the abdomen in the first initial laparotomy. In such surgical clinical scenarios leaving the abdomen open might be lifesaving. Read More

View Article and Full-Text PDF
January 2021

Damage Control Thoracotomy: A Systematic Review of Techniques and Outcomes.

Injury 2021 May 30;52(5):1123-1127. Epub 2020 Dec 30.

Department of Surgery, Indiana University School of Medicine, 340 W. 10(th) St. Fairbanks Hall Suite 6200. Indianapolis, IN, 46202, USA. Electronic address:

Background: Damage control surgery is the practice of delaying definitive management of traumatic injuries by controlling hemorrhage in the operating room and restoring normal physiology in the intensive care unit prior to definitive therapy. Presently, damage control or "abbreviated" laparotomy is used extensively for abdominal trauma in an unstable patient. The application of a damage control approach in thoracic trauma is less established and there is a paucity of literature supporting or refuting this practice. Read More

View Article and Full-Text PDF

[Laparostoma-Avoidance and treatment of complications].

Chirurg 2021 Mar;92(3):283-296

Klinik und Poliklinik für Allgemein‑, Viszeral‑, Transplantations‑, Gefäß- und Kinderchirurgie, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.

The open abdomen (OA) is an established concept for treating severe abdominal diseases. The most frequent reasons for placement of an open abdomen are abdominal sepsis (e.g. Read More

View Article and Full-Text PDF

Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen-An Updated Systematic Review.

Front Surg 2020 5;7:577104. Epub 2020 Nov 5.

Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, Lund, Sweden.

Several different temporary abdominal closure techniques are described in the context of open abdomen treatment. Techniques based on dynamic fascial closure combined with negative pressure therapy have gained popularity and seem to result in the highest fascial closure rates without increased complications and are highlighted in recent guidelines and recommendations. One dynamic closure technique is the vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) technique, first described in 2007. Read More

View Article and Full-Text PDF
November 2020

The Abdominal Re-Approximation Anchor device (ABRA®) has the potential to be useful in both emergency and elective dynamic temporary fascial closure.

ANZ J Surg 2020 12 5;90(12):2456-2462. Epub 2020 Oct 5.

Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Background: The management of an open abdomen (OA) remains an evolving field because of its relative rarity. Many techniques to achieve temporary abdominal closure exist, but often require multiple returns to the operating theatre and usually do not address the issue of lateral fascial retraction and do not achieve primary fascial closure (PFC). The ensuing incisional hernias result in a significant surgical challenge affecting both the physical and mental health of the patient. Read More

View Article and Full-Text PDF
December 2020

Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study.

World J Surg 2020 Dec 24;44(12):4032-4040. Epub 2020 Aug 24.

General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia, 1, 56124, Pisa, Italy.

Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen.

Materials And Methods: A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Read More

View Article and Full-Text PDF
December 2020

Superior primary fascial closure rate and lower mortality after open abdomen using negative pressure wound therapy with continuous fascial traction.

J Trauma Acute Care Surg 2020 12;89(6):1136-1142

From the Department of Abdominal Surgery, Abdominal Center (S.R., P.M., A.L.), Helsinki University Hospital and University of Helsinki, Helsinki; Division of Digestive Surgery and Urology, Department of Surgery (P.S., T.S.), Turku University Hospital, University of Turku, Turku, Department of Surgery, Satakunta Central Hospital, Pori; Department of Abdominal Surgery (V.K.), Oulu University Hospital, Oulo; Department of Gastroenterology and Alimentary Tract Surgery (M.H., L-M.M.), Tampere University Hospital, Tampere; Department of Surgery (T.P.), Seinäjoki Central Hospital, Seinäjoki; Department of Surgery (J.H.), Satakunta Central Hospital, Pori; Department of Surgery (J.R.), Lapland Central Hospital, Rovaniemi; and Department of Surgery (T.R.), Kuopio University Hospital, Institute of Clinical Medicine, University of Eastern Finland, Eastern Finland, Finland.

Background: Open abdomen (OA) is a useful option for treatment strategy in many acute abdominal catastrophes. A number of temporary abdominal closure (TAC) methods are used with limited number of comparative studies. The present study was done to examine risk factors for failed delayed primary fascial closure (DPFC) and risk factors for mortality in patients treated with OA. Read More

View Article and Full-Text PDF
December 2020

Laparostomy and temporary abdominal closure outcomes in emergency non-trauma surgery and parameters affecting early definite primary fascial closure.

Minerva Chir 2020 Dec 26;75(6):419-425. Epub 2020 May 26.

Department of General Surgery, Queen's Hospital, Barking Havering and Redbridge University Hospital NHS Trust, Romford, UK.

Background: The open abdomen or laparostomy is a great advance of surgery based on the concept of damage control surgery. Aim of the study is to review the laparostomy outcomes of non-trauma emergency surgery patients in a district general hospital and identify parameters affecting early definite primary fascial closure.

Methods: The records of all non-trauma emergency surgical patients who underwent laparostomy in a three-year period in a single institute were studied retrospectively. Read More

View Article and Full-Text PDF
December 2020

Open abdomen closure methods for severe abdominal sepsis: a retrospective cohort study.

Eur J Trauma Emerg Surg 2021 Dec 6;47(6):1819-1825. Epub 2020 May 6.

Department of General Surgery, San Giovanni Addolorata Hospital, Rome, Italy.

Purpose: The open abdomen (OA) procedure as part of damage control surgery represents a significant surgical advance in severe intra-abdominal infections. Major techniques used for OA are negative pressure wound therapy (NPWT) and non-NPWT. The aim of this retrospective study is to evaluate the effects of different abdominal closure methods and their outcomes in patients presenting with abdominal sepsis treated with OA. Read More

View Article and Full-Text PDF
December 2021

Use of Nonvascularized Fascia in Liver Transplantation.

Transplant Proc 2020 Jun 21;52(5):1468-1471. Epub 2020 Mar 21.

General Surgery Department. HPB Surgery and Abdominal Organ Transplantation Unit. "Doce de Octubre" University Hospital, Instituto de Investigación (imas12), Complutense University Madrid, Madrid, Spain.

Abdominal wall transplant is developed in the context of intestinal and multivisceral transplant, in which it is often impossible to perform a primary wall closure. Despite the fact that abdominal wall closure is not as consequential in liver transplant, there are circumstances in which it might determine the success of the liver graft, especially in situations that compromise the abdominal cavity and facilitate an abdominal compartment syndrome. CASE 1: A 14-year-old girl suffering from cryptogenic cirrhosis with severe portal hypertension that causes ascites and severe malnutrition. Read More

View Article and Full-Text PDF

Temporary Abdominal Closure Is Associated with Increased Risk for Fungal Intra-Abdominal Infections in Trauma Patients.

Surg Infect (Larchmt) 2020 Nov 18;21(9):745-751. Epub 2020 Mar 18.

Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, USA.

Fungal infections are associated with increased morbidity and death. Few studies have examined risk factors associated with post-operative fungal intra-abdominal infections (FIAIs) in trauma patients after exploratory laparotomy. In this study, we evaluated potential risk factors for acquiring post-operative FIAIs and their impact on clinical outcomes. Read More

View Article and Full-Text PDF
November 2020

Intraabdominal Lavage of Hypochlorous Acid: A New Paradigm for the Septic and Open Abdomen.

Wounds 2020 Apr 23;32(4):107-114. Epub 2020 Jan 23.

University of North Texas, Denton, TX.

Introduction: Management of the open abdomen (OA) has rapidly evolved over the last several decades due to the improved understanding of the underlying pathophysiology of patients with an OA, adoption of damage control surgery, and the use of temporary abdominal closure (TAC) techniques for this patient population. The TAC utilizing negative pressure has been successful for managing patients with an OA with improved time to closure. Recent studies have started to examine the use of TAC in conjunction with negative pressure wound therapy with instillation and dwell time (NPWTi-d) for the management of the OA. Read More

View Article and Full-Text PDF

Immediate Closure of Abdominal Cavity with Biologic Mesh versus Temporary Abdominal Closure of Open Abdomen in Non-Trauma Emergency Patients (CLOSE-UP Study).

Surg Infect (Larchmt) 2020 Oct 25;21(8):694-703. Epub 2020 Feb 25.

Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands.

In more than 10% of emergency laparotomies in non-trauma patients, primary fascial closure is not achievable because of excessive visceral edema, which leaves the patient with an open abdomen (OA). An OA harbors an inherent high risk of serious complications, and temporary closure devices are used to achieve delayed fascial closure. A potential new strategy in preventing OA is immediate closure during the emergency procedure with a non-crosslinked biologic mesh. Read More

View Article and Full-Text PDF
October 2020

Challenge of uncontrolled enteroatmospheric fistulas.

Trauma Surg Acute Care Open 2019 31;4(1):e000381. Epub 2019 Dec 31.

Surgery, Kings County Hospital Center, Brooklyn, New York, USA.

Introduction: With the popularization of damage control surgery and the use of the open abdomen, a new permutation of fistula arose; the enteroatmospheric fistula (EAF), an opening of exposed intestine spilling uncontrollably into the peritoneal cavity. EAF is the most devastating complication of the open abdomen. We describe and analyze a single institution's experience in controlling high-output EAFs in patients with peritonitis. Read More

View Article and Full-Text PDF
December 2019

Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report.

Asian J Endosc Surg 2020 Oct 17;13(4):618-621. Epub 2020 Feb 17.

Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.

Introduction: In closure of a stoma, the small working space and adhesions hinder a precise surgical procedure, compared with conventional approaches to digestive surgery. The aim of this prospective study was to introduce a new technique of laparoscopic stoma closure (LASC).

Materials And Surgical Techniques: After starting with three trocars, it is a priority to dissect around the arising ileum; a linear stapler is precisely inserted in both orifices of the loop stoma and applied two times, extracorporeally. Read More

View Article and Full-Text PDF
October 2020

Entero-atmospheric fistula migration: a new management alternative for complex septic open abdomen.

Anaesthesiol Intensive Ther 2020 ;52(1):56-62

Department of Surgery, Meilahti Hospital, University of Helsinki, Finland.

The open abdomen technique is a surgical strategy used in life-threatening conditions. After recognizing the morbidity and mortality attributed to abdominal compartment syndrome (ACS), several methods were developed to avoid this complication. The primary goal of temporary abdominal closure (TAC) is to create a tension-free closure of the abdomen without increasing intra-abdominal pressure. Read More

View Article and Full-Text PDF
February 2021

Dynamic closure techniques for treatment of an open abdomen: an update.

Hernia 2020 04 5;24(2):325-331. Epub 2020 Feb 5.

Department of General and HPB Surgery and Liver Transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.

Background: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain as it is associated with a high incidence of complications and poor outcomes. The objective is to perform a systematic review on dynamic closure techniques for fascial closure during open abdomen management. Read More

View Article and Full-Text PDF