Hees Anita, Willeke Frank
Department of General, Visceral and Vascular Surgery, Marien Hospital, 57072 Siegen, Germany.
Case Rep Surg. 2020 Oct 21;2020:8254804. doi: 10.1155/2020/8254804. eCollection 2020.
The open abdomen requires intensive and specific treatment efforts. Long hospital admissions, treatment duration, high mortality rates, deferred and delayed wound closures with alloplastic materials or elaborate closure techniques, and the need for subsequent surgical procedures justify and call for implementation of new therapy options. The case presented here demonstrates the use of a new product (Fasciotens Abdomen) to prevent fascial retraction in the open abdomen of an extubated, conscious patient with four-quadrant peritonitis after perforated appendicitis. Controlled, anteriorly directed fascial traction of 50-60 Newtons prevented fascial retraction during open treatment of the abdomen. Once edema was reduced, abdominal closure was completed without difficulty. This new form of therapy was well tolerated by the patient and led to a markedly more rapid abdominal closure without mesh or abdominal wall reconstruction.
开放性腹部需要密集且特定的治疗措施。长时间住院、治疗周期、高死亡率、使用异体材料或复杂的缝合技术延迟和推迟伤口缝合，以及后续手术的必要性，都证明并要求实施新的治疗方案。本文介绍的病例展示了一种新产品（腹直肌牵张器）在一名阑尾穿孔后患有四象限腹膜炎、已拔管且清醒的患者开放性腹部中预防筋膜回缩的应用。50 - 60牛顿的可控、向前的筋膜牵引在腹部开放治疗期间防止了筋膜回缩。一旦水肿减轻，腹部缝合顺利完成。这种新的治疗方式患者耐受性良好，且无需使用补片或腹壁重建就能显著更快地完成腹部缝合。
