Abdominal zippers for temporary abdominal closure in planned relaparotomies for peripancreatic sepsis: experience in
1University of the Philippines College of Medicine and Philippine General Hospital, Taft Avenue, Manila, Philippines 1000.
Background:
Planned relaparotomies have generated renewed interest because of the high mortality rates associated with conventional management techniques in severe intraabdominal sepsis. The use of abdominal zippers for temporary abdominal closure was devised to facilitate repeated explorations, allowing daily cleansing of the peritoneal cavity and the detection and management of septic complications.
Methods:
In our institution, eight patients were managed in a 4-year period, using abdominal zippers for peripancreatic sepsis.
Results:
In all eight patients, subsequent laparotomies allowed the detection of progressive necrosis. Repeated explorations successfully controlled the sepsis in five patients. In three patients, the condition deteriorated, and they died of multiple organ failure.
Conclusions:
The technique warrants further prospective controlled trials in the local setting to ascertain its role in the management of severe intraabdominal sepsis, and in other patients who may require "second-look" operations.
