Gaarder Christine, Naess Pål Aksel, Schwab Charles William, Bjørnbeth Bjørn Atle, Buanes Trond, Pillgram-Larsen Johan
Gastrokirurgisk avdeling, Ullevål universitetssykehus, 0407 Oslo.
Tidsskr Nor Laegeforen. 2004 Nov 4;124(21):2760-2.
Abdominal compartment syndrome(ACS) is a clinical entity characterised by increased intraabdominal pressure leading to multiple organ failure, fatal if left untreated. The treatment of abdominal compartment syndrome is surgical decompression with a temporary abdominal wall substitute. To avoid the development of abdominal compartment syndrome, temporary abdominal closure (TAC) should be considered after celiotomy for trauma. A new method for TAC was introduced at Ullevaal University Hospital in 2002, the "vac pac".
The "vac pac" technique is described and the patients treated with "vac pac" during the first year after introduction are presented.
Five patients were treated using the "vac pac". One patient had acute pancreatitis and developed abdominal compartment syndrome. The other patients were severely injured and the indication for TAC was abdominal compartment syndrome in one patient, intestinal oedema in another, and damage control surgery with packing in two patients. Delayed primary closure was achieved within five days in all our patients. There were no fatalities and no complications related to the use of "vac pac" were registered.
The "vac pac" technique seems to be a good method for TAC.
腹腔间隔室综合征(ACS)是一种临床病症,其特征为腹内压升高导致多器官功能衰竭,若不治疗则会致命。腹腔间隔室综合征的治疗方法是采用临时腹壁替代物进行手术减压。为避免腹腔间隔室综合征的发生,对于创伤性剖腹手术后应考虑采用临时关腹(TAC)。2002年,于勒沃尔大学医院引入了一种新的TAC方法,即“真空袋”法。
描述了“真空袋”技术,并介绍了引入该技术后的第一年中接受“真空袋”治疗的患者情况。
5例患者接受了“真空袋”治疗。1例患者患有急性胰腺炎并发展为腹腔间隔室综合征。其他患者均为重伤,TAC的指征分别为:1例患者为腹腔间隔室综合征,1例为肠水肿,2例为采用填塞法的损伤控制手术。所有患者均在5天内实现了延迟一期缝合。无死亡病例,且未记录到与使用“真空袋”相关的并发症。
“真空袋”技术似乎是一种很好的TAC方法。