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Related Experiment Videos

[Problems with definitive abdominal closure using "zipper" and after "left open abdomen"].

R Hoffmann1, F Largiadèr

  • 1Klinik für Viszeralchirurgie, Universitätsspital Zürich.

Helvetica Chirurgica Acta
|June 1, 1990
PubMed
Summary

Managing a "left open abdomen" presents challenges. Transverse laparotomy is recommended over longitudinal for less retraction, and primary laparostoma is preferred if abdominal wall infection occurs.

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Area of Science:

  • Abdominal surgery
  • Surgical complications
  • Wound management

Background:

  • The management of an open abdomen after surgery poses significant challenges.
  • Current methods for definitive abdominal wall closure, such as split-skin grafts and abdominal zips, have limitations.

Observation:

  • Transverse laparotomy is associated with less abdominal wall retraction compared to longitudinal laparotomy, especially when multiple abdominal lavages are anticipated.
  • Split-skin grafts lack elasticity, leading to tearing with underlying intestinal loops.
  • Abdominal zips are ineffective if intra-abdominal infection compromises the abdominal wall, often tearing away prematurely.

Findings:

  • Primary laparostoma is the preferred treatment when the abdominal wall is infected.
  • Early planning for definitive abdominal closure simplifies the procedure.

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  • The method of temporary abdominal closure does not influence prognosis.

    • Implications:

    • The choice of surgical approach and closure technique significantly impacts patient outcomes in open abdomen management.
    • Prognosis is primarily determined by the underlying pathology and timely resolution of complications, not the temporary closure method.
    • Further research into optimal abdominal wall reconstruction techniques is warranted.