A novel technique for managing open abdomen with the combined use of mesh-mediated traction and the bilateral anterior rectus abdominis sheath turnover flap method: how to do it.

Abstract:

:Proper management of abdominal compartment syndrome and open abdomen is important for improving the survival of critically ill patients. However, in cases requiring a prolonged period of open abdomen, it is frequently difficult to perform definitive fascial closure due to lateralization of the abdominal musculature. We herein present a novel combined technique for managing open abdomen. A 74-year-old male with diffuse peritonitis was transferred to our department, after which a long period of open abdomen made it difficult to achieve fascial closure. Polypropylene mesh was sutured to the fascial edges to reduce the gap, which was then serially tightened under negative pressure wound therapy. However, since it was not possible to accomplish definitive fascial closure, abdominal closure was performed using the bilateral anterior rectus abdominis sheath turnover flap method after removing the mesh, without any complications. This combined technique may be an effective alternative in patients requiring open abdomen with subsequent difficulty in achieving definitive fascial closure.

journal_name

Surg Today

journal_title

Surgery today

authors

Arai M,Kushimoto S,Kim S,Masuno T,Hagiwara J,Ishii H,Yokota H

doi

10.1007/s00595-015-1133-3

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1335-9

issue

10

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-015-1133-3

journal_volume

45

pub_type

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