Erschienen in:
01.01.2007 | INVITED COMMENTARY
Usefulness of the Bilateral Anterior Rectus Abdominis Sheath Turnover Flap Method for Early Fascial Closure in Patients Requiring Open Abdominal Management
verfasst von:
Marc de Moya
Erschienen in:
World Journal of Surgery
|
Ausgabe 1/2007
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Excerpt
Various states of systemic inflammation from trauma to pancreatitis can lead to excessive bowel wall edema and increased intra-abdominal pressures. This peritoneal and visceral edema often precludes the musculofascial closure after celiotomy secondary to undue tension on the fascia. The dramatically increased fascial tension can lead to fascial necrosis or abdominal compartment syndrome. Therefore, abdomens in these scenarios are more frequently closed in a delayed fashion. Dr. Kushimoto and others have presented interesting data concerning the difficult problem of definitive closure of a laparostomy. Approximately 85% of open abdomens are eventually closed by primary repair of the fascia, usually within the first 2 postoperative weeks.
1 However, in a minority of patients continuous resuscitation, contributing to ongoing bowel swelling, and/or retraction of the musculofascial edges with loss of abdominal domain make primary repair impossible. …
