Keramati Magid, Srivastava Anil, Sakabu Stanley, Rumbolo Peter, Smock Michael, Pollack Jonathon, Troop Bryan
Department of Surgery, St. Louis University Hospital, St. Louis, MO, USA.
Burns. 2008 Jun;34(4):493-7. doi: 10.1016/j.burns.2007.06.024. Epub 2007 Oct 18.
Abdominal compartment syndrome is frequently the result of aggressive fluid resuscitation after burn. Management of the open abdomen following decompressive celiotomy is a major problem.
From 2004 to mid-2005, six patients required decompressive celiotomy after developing abdominal compartment syndrome as a result of burn. A Wittmann Patch as used to close the abdominal wound. Patients were re-explored when clinical parameters improved and the abdomen was closed, with long-term follow-up for the abdominal wound.
Of the six patients, five had thermal injury and one had electrical injury. The mean total body surface area affected for thermal burn was 78% and for electrical burn was 37%. Diagnosis of abdominal compartment syndrome was based on elevated bladder pressure and organ dysfunction. The patients were treated with decompressive celiotomy and Wittmann Patch closure. Survivors subsequently underwent primary abdominal closure, with no evidence of ventral hernia at long-term follow-up.
In burn cases with abdominal compartment syndrome, a Wittmann Patch ay prove a helpful method of temporary abdominal closure, followed by primary closure with no complications.
腹腔间隔室综合征常因烧伤后积极的液体复苏所致。减压剖腹术后开放性腹部的处理是一个主要问题。
2004年至2005年年中,6例患者因烧伤导致腹腔间隔室综合征而需要进行减压剖腹术。使用维特曼补片关闭腹部伤口。当临床参数改善且腹部关闭时,对患者进行再次探查,并对腹部伤口进行长期随访。
6例患者中,5例为热烧伤,1例为电烧伤。热烧伤的平均体表面积受累为78%,电烧伤为37%。腹腔间隔室综合征的诊断基于膀胱压力升高和器官功能障碍。患者接受减压剖腹术和维特曼补片关闭治疗。幸存者随后进行了一期腹部关闭,长期随访无腹疝证据。
在伴有腹腔间隔室综合征的烧伤病例中,维特曼补片可能是一种有用的临时腹部关闭方法,随后进行一期关闭且无并发症。