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Related Experiment Videos

Experience with three prosthetic materials in temporary abdominal wall closure

K K Nagy1, J J Fildes, C Mahr

  • 1Department of Trauma, Cook County Hospital, Chicago, Illinois, USA.

The American Surgeon
|May 1, 1996
PubMed
Summary

For trauma patients needing temporary abdominal wall closure, Goretex prostheses are recommended. They offer better outcomes and fewer complications like fistulas compared to Marlex or Dexon, making them the optimal choice.

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Area of Science:

  • Trauma Surgery
  • Surgical Materials Science

Background:

  • Abdominal wall closure after laparotomy for trauma can be unsafe or impossible.
  • Prosthetic materials are sometimes necessary for temporary abdominal wall closure in critical cases.

Purpose of the Study:

  • To determine the optimal prosthetic material for temporary abdominal wall closure in trauma patients.
  • To compare the outcomes of Marlex, Dexon, and Goretex prostheses in this patient population.

Main Methods:

  • Retrospective chart review of 25 trauma patients who received 31 abdominal wall prostheses over 4 years.
  • Analysis of patient demographics, injury severity, and prosthetic type (Marlex, Dexon, Goretex).
  • Evaluation of patient outcomes including mortality, hernia formation, fistula development, and wound complications.

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Main Results:

  • Goretex prostheses were associated with fewer complications, including less inflammatory reaction and lower fistula formation rates.
  • Dexon prostheses led to a high incidence of large hernias and complications, including one death from evisceration.
  • Marlex prostheses showed a high rate of fistula formation due to erosion into the gastrointestinal tract, leading to abandonment of its use.
  • Eight patients died due to ongoing shock or multiple organ failure, irrespective of the prosthetic material used.

Conclusions:

  • Goretex is the preferred prosthetic for temporary abdominal wall closure in trauma patients due to its biocompatibility and lower complication rates.
  • The use of Marlex for abdominal wall closure has been discontinued due to significant fistula risks.
  • Dexon prostheses are associated with severe hernia complications, necessitating careful consideration of their use.