Abstract Open abdomen (OA) has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient’s physiological condition allows.

A couple of days later, he reopened the incision (49002) and placed a Wittmann patch and a wound vac (97605). On 4 separate occasions after that, he opened the patch, inspected the abdominal cavity, performed lavage, closed the patch and reapplied the wound vac (97605).

Charu nivedita books pdf free download 2017. Since the late 1980's the concept of damage control laparotomy has emerged as a mainstay in the armamentarium of the trauma surgeon. In order to avoid the letha triad of hypothermia, coagulopathy, and metabolic acidosis; operations have been abruptly terminated after control of hemorrhage. Methods for temporary abdominal closure have subsequently evolved.

Mac os x 102 jaguar download iso 1. This temporary abdominal closure technique employs a Velcro like material that is sutured to the fascia of the abdominal wall. This method allows for reexploration of the abdomen as well as slow re-approximation of the abdominal wall over a period of days. This makes if possible to perform a delayed primary closure of the fascia. Trauma patients that once may have gone on to develop ventral hernieas with other temporary closure modalities are now able to be closed primarily.