Early Definitive Closure of the Open Abdomen: A Quiet Revolution

Contrary to the management strategy recommended only 2-3 years ago, temporarily covering the open abdomen with an absorbable mesh or a plastic sheath without preserving the peritoneal space is no longer considered in the patient's best interest. The use of the vacuum pack, in conjunction with v...

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Bibliographic Details
Published in:Scandinavian Journal of Surgery 2005-03, Vol.94 (1), p.9-14
Main Authors: Scott, B. G., Feanny, M. A., Hirshberg, A.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Humans
Laparotomy - methods
Surgical Mesh
Surgical Procedures, Operative - methods
Suture Techniques
Time Factors
Treatment Outcome
Vacuum
Wound Healing
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Summary:Contrary to the management strategy recommended only 2-3 years ago, temporarily covering the open abdomen with an absorbable mesh or a plastic sheath without preserving the peritoneal space is no longer considered in the patient's best interest. The use of the vacuum pack, in conjunction with vacuum-assisted wound management and new biological prostheses now offer patients with an open abdomen a better and simpler alternative to the giant "planned ventral hernia". With very few exceptions in the most critically ill patients, the survivors of damage control surgery or infected pancreatic necrosis should not be sent home with a huge defect only to undergo a complex reconstruction a year later. Simpler and better alternatives exist. The new concepts and technologies presented in this review, when widely adopted, will rapidly translate into safer and better management of the patient with an open abdomen.
ISSN:1457-4969
1799-7267
DOI:10.1177/145749690509400104