251 results match your criteria Temporary Abdominal Closure Techniques


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

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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

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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

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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

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[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

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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

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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

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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

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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

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December 2020

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

Eur J Trauma Emerg Surg 2020 May 6. 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

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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

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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

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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

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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

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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

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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

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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

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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

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Intra-abdominal pressure may be elevated in patients with open abdomen after emergent laparotomy.

Langenbecks Arch Surg 2020 Feb 18;405(1):91-96. Epub 2020 Jan 18.

Department General Surgery B, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Be'er Sheva, Israel.

Purpose: To estimate the change in intra-abdominal pressure (IAP) among critically ill patient who were left with open abdomen and temporary abdominal closure after laparotomy, during the first 48 h after admission.

Methods: A cohort study in a single ICU in a tertiary care hospital. All adult patients admitted to the ICU after emergent laparotomy for acute abdomen or trauma, who were left with temporary abdominal closure (TAC), were included. Read More

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February 2020

Bogota Bag Temporary Abdominal Closure Surgical Technique in Children: A 15-Year Single Center Experience.

Isr Med Assoc J 2020 Jan;22(1):43-47

Pediatric Intensive Care Unit, Soroka University Medical Center, Beer Sheva, Israel.

Background: Temporary abdominal closure (TAC) surgical technique relates to a procedure in which the post-surgical abdominal wall remains open in certain indications. The Bogota bag (BB) technique is a tension-free TAC method that covers the abdominal contents with a sterilized fluid bag. There are very few reports of pediatric patients treated with this technique. Read More

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January 2020

Polycompartment syndrome - intra-abdominal pressure measurement.

Authors:
Zsolt Bodnar

Anaesthesiol Intensive Ther 2019 ;51(4):316-322

Department of Surgery, Letterkenny University Hospital, Letterkenny, Ireland.

Intra-abdominal hypertension and the abdominal compartment syndrome are well-known, serious, life-threatening clinical entities in acute care surgery. A common characteristic of these syndromes is the permanent and irreversible damage that may affect the organs which can be found inside the given compartment if quick intervention cannot be provided. All factors which may and can lead to a sudden increase in the intra-abdominal pressure can be found among the triggering factors of abdominal compartment syndrome. Read More

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Myths and realities in the management of the open abdomen with negative pressure systems. A case report and literature review.

Int J Surg Case Rep 2019 22;61:174-179. Epub 2019 Jul 22.

General surgery department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, Mexico.

Introduction: The open abdomen is a useful resource for treating patients with abdominal hypertension and abdominal compartment syndrome. Currently, early closure assisted with negative pressure devices is considered standard of treatment, and its use has demonstrated favorable outcomes and a decreased rate of complications.

Presentation Of A Case: We present a case of a 32-year-old male patient with diagnosis of non-seminomatous germinal testicular tumor (Stage IIIB (T3-N3-M1), which was summited to surgery, as a complication he presented massive bleeding, that culminated in acute compartment syndrome. Read More

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Open abdomen in acute mesenteric ischemia.

Anaesthesiol Intensive Ther 2019 ;51(2):159-162

Heart Center, Kuopio University Hospital, Kuopio, Finland.

In acute mesenteric ischemia, early diagnosis should optimally be followed by either open or endovascular intestinal revascularization. All too often, diagnosis is delayed and diagnosis and treatment are performed at the same time during explorative laparotomy. The majority of patients will be diagnosed when transmural intestinal infarction has developed and at this time point damage control strategies involving intestinal revascularization, bowel resection, open abdomen and second look may be necessary to salvage the patient. Read More

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Outcomes of open abdomen versus primary closure following emergent laparotomy for suspected secondary peritonitis: A propensity-matched analysis.

J Trauma Acute Care Surg 2019 09;87(3):623-629

From the Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC (A.M.K., L.N.C., M.B-G., T.P., B.T.H., B.R.D., K.R.K.).

Background: Optimal management following index laparotomy is poorly defined in secondary peritonitis patients. Although "open abdomen" (OA), or temporary abdominal closure with planned relaparotomy, is used to reassess bowel viability or severity of contamination, recent studies demonstrate comparable morbidity and mortality with primary abdominal closure (PC). This study evaluates differences between OA and PC following emergent laparotomy. Read More

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September 2019

Effects of Early Altitude Exposure on the Open Abdomen After Laparotomy in Trauma.

Mil Med 2019 10;184(9-10):e460-e467

Department of Surgery, College of Medicine, University of Cincinnati, Section of General Surgery, OH.

Introduction: While damage control surgery and resuscitation techniques have revolutionized the care of injured service members who sustain severe traumatic hemorrhage, the physiologic and inflammatory consequences of hemostatic resuscitation and staged abdominal surgery in the face of early aeromedical evacuation (AE) have not been investigated. We hypothesized that post-injury AE with an open abdomen would have significant physiologic and inflammatory consequences compared to AE with a closed abdomen.

Materials And Methods: Evaluation of resuscitation and staged abdominal closure was performed using a murine model of hemorrhagic shock with laparotomy. Read More

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October 2019

Blurring the boundary between open abdomen treatment and ventral hernia repair.

Langenbecks Arch Surg 2019 Jun 7;404(4):489-494. Epub 2019 Feb 7.

Department of Visceral and Transplant Surgery, University Hospital Zurich, Rämistrasse 100, CH-8091, Zürich, Switzerland.

Purpose: Therapeutic approaches for septic open abdomen treatment remain a major challenge with many uncertainties. The most convincing method is vacuum-assisted wound closure with mesh-mediated fascia traction with a protective plastic sheet placed on the viscera. As this plastic sheet and the mesh must be removed before final fascial closure, such a technique only allows temporary abdominal closure. Read More

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Vacuum-Assisted Wound Closure and Permanent Onlay Mesh-Mediated Fascial Traction: A Novel Technique for the Prevention of Incisional Hernia after Open Abdomen Therapy Including Results From a Retrospective Case Series.

Scand J Surg 2019 Sep 21;108(3):216-226. Epub 2018 Dec 21.

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

Background And Aims: Incisional hernia development is a frequent long-term sequel after open abdomen treatment. This report describes a novel technique, the vacuum-assisted wound closure and permanent onlay mesh-mediated fascial traction for temporary and final closure of the open abdomen, with the intention to decrease incisional hernia rates. Primary aim was to evaluate incisional hernia development and secondary aims to describe short-term complications and patient-reported outcome. Read More

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September 2019

The impact of standardized protocol implementation for surgical damage control and temporary abdominal closure after emergent laparotomy.

J Trauma Acute Care Surg 2019 04;86(4):670-678

From the Department of Surgery (T.J.L., P.A.E., T.M.B., M.D.R., C.A.C., M.S.W., R.S.S., F.A.M., A.M.M., S.C.B.), University of Florida Health, Gainesville, Florida; and Sepsis and Critical Illness Research Center (T.J.L., P.A.E., M.D.R., F.A.M., A.M.M., S.C.B.), University of Florida Health, Gainesville, Florida.

Background: To standardize care and promote early fascial closure among patients undergoing emergent laparotomy and temporary abdominal closure (TAC), we developed a protocol addressing patient selection, operative technique, resuscitation strategies, and critical care provisions. We hypothesized that primary fascial closure rates would increase following protocol implementation with no difference in complication rates.

Study Design: We performed a retrospective cohort analysis of 138 adult trauma and emergency general surgery patients who underwent emergent laparotomy and TAC, comparing protocol patients (n = 60) to recent historic controls (n = 78) who would have met protocol inclusion criteria. Read More

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Outcomes of selective nonoperative management of civilian abdominal gunshot wounds: a systematic review and meta-analysis.

World J Emerg Surg 2018 27;13:55. Epub 2018 Nov 27.

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Civic Campus, Room A280, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9 Canada.

Background: Although mandatory laparotomy has been standard of care for patients with abdominal gunshot wounds (GSWs) for decades, this approach is associated with non-therapeutic operations, morbidity, and long hospital stays. This systematic review and meta-analysis sought to summarize outcomes of selective nonoperative management (SNOM) of civilian abdominal GSWs.

Methods: We searched electronic databases (March 1966-April 1, 2017) and reference lists of articles included in the systematic review for studies reporting outcomes of SNOM of civilian abdominal GSWs. Read More

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February 2019