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Temporary closure of the abdominal wall (laparostomy)
A Schachtrupp1, V Fackeldey, U Klinge
1Department of Surgery, Rhenish Westphalian Technical University, Pauwelsstr 30, 52074 Aachen, Germany. Alexander.Schachtrupp@post.rwth-aachen.de
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|November 9, 2002
Summary
Temporary abdominal wall closure, often needed for conditions like peritonitis or trauma, commonly uses mesh. Absorbable mesh is preferred despite potential incisional hernias, as non-absorbable types risk severe complications.
Area of Science:
- Surgical innovation
- Abdominal surgery
- Wound healing
Background:
- Definitive abdominal wall closure is not always feasible for conditions like peritonitis, trauma, or mesenteric ischemia.
- Temporary abdominal wall closure (laparostomy) is used to facilitate re-exploration or prevent abdominal compartment syndrome.
Purpose of the Study:
- To review the current practices and materials used for temporary abdominal wall closure.
- To compare the outcomes and complications associated with different mesh materials.
Main Methods:
- Review of existing literature and common surgical practices regarding temporary abdominal wall closure.
- Discussion of the advantages and disadvantages of mesh materials (absorbable vs. non-absorbable).
Main Results:
- Mesh materials offer benefits like drainage, visual control, access, fascial preservation, secondary intention healing, and patient mobilization.
- Non-absorbable meshes are linked to enteric fistulae and infection, requiring explantation.
- Absorbable meshes have fewer infectious complications but can lead to incisional hernias requiring later repair.
Conclusions:
- Absorbable mesh materials are commonly used for temporary abdominal wall closure, representing the current standard of care.
- While leading to incisional hernias, absorbable meshes avoid the severe infectious complications associated with non-absorbable options.