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Titolo:
TEMPORARY CLOSURE OF OPEN ABDOMINAL WOUNDS - THE VACUUM PACK
Autore:
BROCK WB; BARKER DE; BURNS RP;
Indirizzi:
SUITE 400,921 E 3RD ST CHATTANOOGA TN 37403 UNIV TENNESSEE,COLL MED,DEPT SURG CHATTANOOGA TN 37401
Titolo Testata:
The American surgeon
fascicolo: 1, volume: 61, anno: 1995,
pagine: 30 - 35
SICI:
0003-1348(1995)61:1<30:TCOOAW>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLANNED MULTIPLE LAPAROTOMIES; OPEN MANAGEMENT; GENERALIZED PERITONITIS; DIFFUSE PERITONITIS; SEPTIC ABDOMEN; MARLEX MESH; WALL; PRESSURE; ZIPPER; ETAPPENLAVAGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
44
Recensione:
Indirizzi per estratti:
Citazione:
W.B. Brock et al., "TEMPORARY CLOSURE OF OPEN ABDOMINAL WOUNDS - THE VACUUM PACK", The American surgeon, 61(1), 1995, pp. 30-35

Abstract

Temporary closure of abdominal surgical wounds is occasionally required when conditions of the abdominal wall or peritoneal cavity prevent closure or when early re-exploration is planned. The optimal temporaryclosure should contain and protect the contents of the peritoneal cavity from external contamination and injury; preserve the integrity of the abdominal wall; be simple to perform and maintain; provide ease ofreentry; and have minimal adverse physiologic effects. Based on thesecriteria, a method of temporary abdominal wound closure (termed the vacuum pack) has been designed and evaluated. The operative technique includes 1) placement of a fenestrated polyethylene sheet between the abdominal viscera and anterior parietal peritoneum; 2) placement of a moist, sterile laparotomy towel over the polyethylene sheet; 3) placement of two closed suction drains over the towel; 4) placement of an adhesive backed drape over the entire wound, including a wide margin of surrounding skin; and 5) suction applied to the drains, creating a vacuum and rigid compression of the layers of closure material. This creates a tight, external seal of the adhesive backed drape and facilitatesdrainage of the peritoneal cavity. From April 1992-December 1993, this temporary abdominal wound closure was performed 56 times in 28 patients, ages 6-78 years, for periods of 1-11 days. The procedure was usedin 17 trauma patients and 11 non-trauma patients. Indications for useincluded increased intra-abdominal pressure in nine, mandatory re-exploration in 10, and a combination of these indications in nine patients. Pre- and postprocedural airway and systemic blood pressures were unaffected by this closure. All closures remained intact until removed, and there were no eviscerations or abdominal wall injuries. Overall in-hospital mortality was 37.5%, none related to the vacuum pack. Twenty-one patients underwent either primary fascial closure (n = 14), or staged closure (n = 7). The vacuum pack has proven useful for temporary closure of abdominal wounds.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 16:16:56