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KMID : 1033220200100030083
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Journal of Acute Care Surgery
2020 Volume.10 No. 3 p.83 ~ p.89
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A Feasible Operative Treatment Strategy for Trauma Patient with Difficulties in Closing the Abdomen during Open Abdomen Management (OAM) Following Damage Control Surgery-Secondary Publication
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Nagashima Futoshi
Inoue Satoshi
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Abstract
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The vacuum packing closure (VPC) is often performed as temporal abdominal closure after damage control surgery (DCS). We occasionally encounter severe trauma patients whose abdomens were unable to be closed after DCS. The bilateral anterior rectus abdominis sheath flap turnover method and component separation (CS) method are one of the options to close the abdomen. However, it can be challenging to close the abdomen in some patients with very severe trauma or obesity by these methods. The open abdomen management (OAM) with a planned ventral hernia can be performed in those patients. The patients with long term OAM occasionally develop persistent enteroatmospheric fistula (EAF). The VPC using absorbable mesh is useful to reduce the likelihood of EAF. The posterior component separation with transversus abdominis release is a useful method for delayed abdominal wall reconstruction following planned VH if bilateral anterior rectus abdominis sheath flap turnover method and CS method are unable to be performed.
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KEYWORD
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abdominal wound closure techniques, fistula, surgery, trauma
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