Sequential closure of the abdominal wall for the management of open abdomen. A new surgical technique
Efrén Flores-Álvarez1, J Cruz De la Torre-González1, Virgilio Rivera-Barragán1
1Departamento de Enseñanza e Investigación y Servicio de Cirugía General, Centenario Hospital Miguel Hidalgo, Aguascalientes, México.
Background:
The open abdomen is a surgical technique used in the treatment of patients with abdominal sepsis, abdominal trauma and abdominal hypertension syndrome.
Objective:
The aim was to demonstrate the effectiveness of a new surgical technique designed for the management and closure of the abdominal wall in patients with open abdomen.
Method:
Study of all patients treated with open abdomen in our Hospital over a five-year period.
Results:
It were included 24 patients, 18 men and 6 women. The average age was 41.5 ± 15.9 years. Operative diagnosis was abdominal compartment syndrome in 7 (29%) cases, abdominal sepsis in 9 (38%), and abdominal trauma in 8 (33%). The median of APACHE II score was 8 points (range: 5-21) while the assessment of SIRS score had a median of 2 points (range: 1-4). The median of surgical procedures performed in operating room was two per patient. The median of fascial surgical closures performed in the patient bed was four. A successful closure of the abdominal wall was performed in 21 of 22 live patients (95%).
Conclusions:
The sequential closure of the abdominal wall is an effective technique that offers an alternative to the management of the open abdomen.
