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[Skin-adipose tissue detachment for laparotomy closure: a simple and effective technique for a complex problem].

Domingos André Fernandes Drumond¹

¹Hospital João XXIII, Hospitalar do Estado de Minas Gerais, Belo Horizonte. dandrefernandes@gmail.com

Revista Do Colegio Brasileiro De Cirurgioes

|November 17, 2010

Summary

This study presents a simple, safe, and low-cost technique for closing open abdomens by detaching cutaneous-adipose tissues. It offers a viable therapeutic option for patients when fascial closure is not immediately possible, showing good patient outcomes.

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Area of Science:

Surgical technique for abdominal wall reconstruction.
Management of open abdomen.
Wound healing and hernia prevention.

Context:

Open abdomen management presents significant challenges, often requiring complex reconstructive procedures.
The Bogota bag technique is frequently used for temporary abdominal closure.
Delayed fascial closure can lead to complications like ventral hernias.

Purpose:

To describe a novel technique for laparotomy closure using cutaneous-adipose tissue detachment.
To evaluate the safety, efficacy, and patient outcomes of this specific closure method.
To present this technique as an alternative for open abdomen management.

Summary:

A cohort of 40 patients with open abdomens (Bogota bag) underwent closure via cutaneous-adipose tissue detachment.

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The majority of patients were male (95%) with high injury severity scores (ISS 28.78, APACHE II 20), often due to gunshot wounds (70%).

Ventral hernias occurred in 81.5%, but only two patients reported dissatisfaction; no deaths or fistulas were observed.

Impact:

The described technique is simple, safe, and cost-effective for managing open abdomens.
It serves as a valuable therapeutic option, particularly when primary fascial closure is delayed (7-10 days).
This method can improve patient outcomes by providing a stable closure, reducing hernia incidence, and avoiding severe complications.