Nouh Thamer, Alburakan Ahmed, Alawi Khalil, Alshahwan Nawaf, Mashbari Hassan, Alowais Jalal, Khalaf Walid
Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
Sci Rep. 2025 May 22;15(1):17758. doi: 10.1038/s41598-025-99910-z.
Managing open abdomens in critically ill patients after damage control surgery is complex and challenging. Delay in definitive surgery reduces successful primary fascial closure increasing complications. Early abdominal wall closure can improve patient outcomes and reduce risks. We retrospectively reviewed all patients who had the abdominal re-approximation anchor applied to achieve primary fascial closure at our institution. The electronic health record was reviewed for demographics, open abdomen indication, total number of operations, time to primary closure, success rate of primary fascial closure, and complications related to the use of the system. Between May 2015 and May 2018, we applied the abdominal re-approximation anchor system to 7 patients managed with open abdomens. Intra-peritoneal sepsis was the indication in 4 patients while the rest were secondary to trauma. The system was applied after an average of 4.7 ± 1.9 days. The fascia was retracted an average of 19 ± 1.5 cm. Tension free fascial closure was achieved in all patients after an average of 5.4 ± 2 days. Early application of the abdominal re-approximation anchor system was associated with achieving tension free delayed primary fascia closure in all our patients with no major abdominal complications.
在损伤控制手术后处理危重症患者的开放性腹部是复杂且具有挑战性的。确定性手术的延迟会降低初次筋膜缝合成功的几率，增加并发症。早期腹壁闭合可改善患者预后并降低风险。我们回顾性分析了在我们机构应用腹部重新靠拢锚定装置以实现初次筋膜闭合的所有患者。查阅电子健康记录以获取人口统计学信息、开放性腹部的指征、手术总数、初次闭合时间、初次筋膜闭合成功率以及与该系统使用相关的并发症。2015年5月至2018年5月期间，我们对7例开放性腹部患者应用了腹部重新靠拢锚定系统。4例患者的指征为腹腔内脓毒症，其余患者继发于创伤。该系统平均在4.7±1.9天之后应用。筋膜平均回缩19±1.5厘米。所有患者平均在5.4±2天后实现了无张力筋膜闭合。早期应用腹部重新靠拢锚定系统与我们所有患者实现无张力延迟初次筋膜闭合且无重大腹部并发症相关。
