Staged management of the open abdomen and enteroatmospheric fistulae using split-thickness skin grafts.

Abstract:

BACKGROUND:Management of the open abdomen with polyglactin 910 mesh followed by split-thickness skin grafts allows safe, early closure of abdominal wounds. This technique can be modified to manage enteroatmospheric fistulae. Staged ventral hernia is performed in a less inflamed surgical field. METHODS:A retrospective review was performed of 59 consecutive patients who underwent abdominal skin grafting for open abdominal wounds from 2001 to 2011. RESULTS:The median length of follow-up was 215 days. Thirty-one percent of patients presented with preexisting enteroatmospheric fistulae, and 41% required polyglactin 910 mesh placement before skin grafting. Partial or complete skin graft failure occurred in 7 patients. Four patients required repeat skin grafting. All patients ultimately achieved abdominal wound closure, and none developed de novo fistulae. CONCLUSIONS:With proper technique, skin grafting of the open abdomen with a planned ventral hernia repair is a safe and effective alternative to delayed primary closure.

journal_name

Am J Surg

authors

Cheesborough JE,Park E,Souza JM,Dumanian GA

doi

10.1016/j.amjsurg.2013.07.040

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

504-11

issue

4

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(13)00616-8

journal_volume

207

pub_type

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