Scientific paperReinforced silicone elastomer sheeting, an improved method of temporary abdominal closure in damage control laparotomy
Section snippets
Patients and methods
We performed a retrospective review of all patients admitted to Harborview Medical Center (HMC) requiring temporary abdominal closure with nylon reinforced silicone elastomer sheet from 1991 to 2000. During the study period, there were 21,414 admissions to our general/trauma, vascular, and thoracic surgery services and 39,517 total trauma admissions. The material was initially manufactured and supplied by Dow Corning (Silastic; Toledo, Ohio) and since 1995 by Bentec Medical (Sacramento,
Results
All patients requiring temporary abdominal closure with nylon reinforced silicone elastomer membrane from 1991 to 1999 were identified. There were 134 patients who underwent closure with silicone elastomer. Application of silicone elastomer for closure increased with time (Fig. 1). The principal diagnoses and primary indications for temporary abdominal closure are demonstrated in Table 1. Trauma was the most frequent primary diagnosis with blunt mechanism in 62 (46%) and a penetrating
Comments
The open abdomen, although reported decades earlier, is in part a “disease of technology” resulting from more aggressive fluid administration, damage control laparotomy, and modern critical care advances. Often life-saving, decompressive laparotomy carries with it the responsibility of restoring anatomic continuity of the abdominal wall. The surgeon should choose the method most likely to result in fascial closure. Numerous options have coevolved in the last decade as surgeons sought solutions
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