Department of Plastic Surgery, Tampere University Hospital, Tampere, Finland.
Scand J Surg. 2013;102(1):20-4. doi: 10.1177/145749691310200105.
"Open abdomen" is a strategy used to avoid or treat abdominal compartment syndrome. It has reduced mortality both in trauma and non-trauma abdominal catastrophes but also has created a challenging clinical problem. Traditionally, open abdomen is closed in two phases; primarily with a free skin graft and later with a flap reconstruction. A modern trend is to close the abdomen within the initial hospitalization. This requires multi-professional co-operation. Temporary abdominal closure methods, e.g. negative pressure wound therapy alone or combined with mesh-mediated traction, have been developed to facilitate direct fascial closure. Components separation technique, mesh reinforcement or bridging of the fascial defect with mesh and perforator saving skin undermining can be utilized in the final closure if needed. These techniques can be combined. Choice of the treatment depends on the condition of the patient and size of the fascia and skin defect, and the state of the abdominal contents. In this paper we review the literature on the closure of an open abdomen and present the policy used in our institution in the open abdomen situations.
“开放性腹部”是一种用于避免或治疗腹腔间隔室综合征的策略。它降低了创伤和非创伤性腹部灾难的死亡率，但也带来了具有挑战性的临床问题。传统上，开放性腹部通过两个阶段进行关闭；主要是使用游离皮片，然后使用皮瓣重建。一种现代趋势是在最初的住院期间关闭腹部。这需要多专业的合作。已经开发了临时腹部关闭方法，例如单独使用负压伤口治疗或与网片介导的牵引结合使用，以促进直接筋膜闭合。如果需要，可在最终关闭时使用筋膜分离技术、网片加固或网片桥接筋膜缺损以及穿支皮瓣游离皮瓣。这些技术可以结合使用。治疗方法的选择取决于患者的状况、筋膜和皮肤缺损的大小以及腹部内容物的状态。本文我们回顾了关于开放性腹部闭合的文献，并介绍了我们机构在开放性腹部情况下使用的政策。
