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The open abdomen. The Marlex mesh and zipper technique: a method of managing intraperitoneal infection
G L Walsh1, P Chiasson, G Hedderich
1General Surgery, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
Abstract:
In conclusion, a zipper technique has been outlined that allows effective continuing drainage of the septic abdomen, permits early diagnosis of organ damage, is rapid and cost effective, minimizes ventilator dependency and gastrointestinal complications, is well tolerated by the patients, and has produced a modest 65 per cent survival rate in the first 34 critically ill patients in whom it was used. Selection of patients is critical. It is a technique that must not be undertaken lightly but that appears to have life-saving potential.
Insights
A novel zipper technique offers effective septic abdomen drainage, aiding early organ damage diagnosis. This cost-effective method improves survival rates in critically ill patients.
Area of Science:
- Surgical techniques
- Critical care medicine
- Abdominal surgery
Background:
- Septic abdomen presents significant challenges in critically ill patients.
- Effective drainage and early diagnosis of organ damage are crucial for patient outcomes.
- Minimizing complications like ventilator dependency and gastrointestinal issues is a key goal in intensive care.
Purpose of the Study:
- To outline a novel zipper technique for managing septic abdomen.
- To evaluate the efficacy and safety of this technique in critically ill patients.
- To assess the impact of the technique on patient survival and complications.
Main Methods:
- A zipper technique was developed for continuous drainage of the septic abdomen.
- The technique was applied to 34 critically ill patients.
- Patient outcomes, including diagnosis of organ damage, complications, and survival rates, were monitored.
Main Results:
- The zipper technique facilitated effective and continuous septic abdomen drainage.
- Early diagnosis of organ damage was enabled by the technique.
- The technique demonstrated a 65% survival rate in the initial cohort of 34 critically ill patients.
- Reduced ventilator dependency and gastrointestinal complications were observed.
Conclusions:
- The zipper technique is a viable option for managing septic abdomen in critically ill patients.
- Patient selection is critical for successful application of this technique.
- While not without risks, the technique shows life-saving potential.