Rasilainen S K, Mentula P J, Leppäniemi A K
Department of Abdominal Surgery, Jorvi Hospital, Espoo, Finland
Department of Abdominal Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Scand J Surg. 2016 Mar;105(1):17-21. doi: 10.1177/1457496915586651. Epub 2015 May 13.
The goal after open abdomen treatment is to reach primary fascial closure. Modern negative pressure wound therapy systems are sometimes inefficient for this purpose. This retrospective chart analysis describes the use of the 'components separation' method in facilitating primary fascial closure after open abdomen.
A total of 16 consecutive critically ill surgical patients treated with components separation during open abdomen management were analyzed. No patients were excluded.
Primary fascial closure was achieved in 75% (12/16). Components separation was performed during ongoing open abdomen treatment in 7 patients and at the time of delayed primary fascial closure in 9 patients. Of the former, 3/7 (43%) patients reached primary fascial closure, whereas all 9 patients in the latter group had successful fascial closure without major complications (p = 0.019).
Components separation is a useful method in contributing to successful primary fascial closure in patients treated for open abdomen. Best results were obtained when components separation was performed simultaneously with primary fascial closure at the end of the open abdomen treatment.
开放性腹部治疗后的目标是实现一期筋膜闭合。现代负压伤口治疗系统有时在此目的上效率不高。本回顾性图表分析描述了“成分分离”方法在促进开放性腹部术后一期筋膜闭合中的应用。
分析了16例在开放性腹部处理期间接受成分分离治疗的连续重症外科患者。无患者被排除。
75%(12/16)的患者实现了一期筋膜闭合;7例患者在开放性腹部治疗期间进行了成分分离,9例患者在延迟一期筋膜闭合时进行了成分分离。在前者中,3/7(43%)的患者实现了一期筋膜闭合,而后者组中的所有9例患者均成功进行了筋膜闭合且无重大并发症(p = 0.019)。
成分分离是有助于开放性腹部治疗患者成功实现一期筋膜闭合的有用方法。在开放性腹部治疗结束时与一期筋膜闭合同时进行成分分离可获得最佳结果。