[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.
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.
- 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.
