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Related Experiment Videos

A proposed algorithm for managing the open abdomen.

James Cipolla1, Stanislaw P Stawicki, William S Hoff

  • 1Department of Surgery, St. Luke's Hospital and Health Network, Bethlehem, Pennsylvania 18015, USA.

The American Surgeon
|May 5, 2005
PubMed
Summary

Managing an open abdomen can be achieved with a combined algorithm of techniques, including vacuum-assisted fascial closure and delayed primary closure, leading to minimal morbidity and acceptable closure rates.

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Area of Science:

  • Surgical Management
  • Abdominal Surgery
  • Trauma Surgery

Background:

  • Delayed abdominal closure is increasingly accepted for various surgical conditions.
  • Safe, uncomplicated, and expeditious fascial closure techniques are crucial.

Purpose of the Study:

  • To evaluate an algorithm combining multiple techniques for managing open abdomens.
  • To assess morbidity and closure rates in patients with open abdomens.

Main Methods:

  • Retrospective review of 20 patients with open abdomens (September 2001 - June 2004).
  • Algorithm included vacuum-assisted fascial closure (VAFC), delayed primary closure (DPC), Wittmann Patch (WP), and planned ventral hernia (PVH).
  • Patients underwent VAFC initially, with re-exploration at 12-48 hours.

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Main Results:

  • 17 patients were analyzed; 28-day mortality was 5.9% (1/17).
  • Enterocutaneous fistulae occurred in 11.7% (2/17) of patients.
  • Successful fascial closure was achieved in 35.3% (6/17) of patients; 11 patients underwent PVH.

Conclusions:

  • An algorithm combining VAFC, DPC, WP, and PVH can effectively manage open abdomens.
  • This approach results in minimal morbidity and acceptable fascial closure rates.
  • The study highlights the utility of a multi-technique strategy for complex abdominal wall reconstruction.