289 results match your criteria: "Temporary Abdominal Closure Techniques"

Introduction: As research advances in vascularized composite allotransplantation (VCA), large animal models are essential for translational studies related to immune rejection and graft survival. However, procurement of large flaps can cause significant defects, complicating wound closure and increasing postoperative risks. This study details the surgical techniques and outcomes of autologous vertical rectus abdominis myocutaneous (VRAM) flap transplantation and neck flap isolation with induced ischemia in a swine model.

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Introduction: Abdominal wall closure in postoperative burst abdomen remains challenging. Different techniques vary between definitive closure and temporary closure. The aim of this study was to examine the short-term outcomes for different closure techniques.

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Introduction: Abdominal compartment syndrome (ACS) poses a significant clinical challenge, with high morbidity and mortality rates. Conventional treatment via decompressive laparotomy with open abdomen and temporary closure presents significant drawbacks. This experimental study evaluates the efficacy of open minimally invasive sequential fasciotomy in managing simulated ACS in a porcine model.

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Introduction: Open abdomen (OA) therapy is used in the management of patients who require surgery for severe abdominal conditions. This meta-analysis aims to evaluate the VAWCM technique regarding short and long-term outcomes.

Methods: PubMed, Embase, and Cochrane Central were systematically searched for studies that analyzed VAWCM therapy in OA.

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Article Synopsis
  • The study examined outcomes of temporary abdominal closure compared to primary closure after nontrauma emergency surgeries, focusing on a standardized care approach at a Danish hospital.
  • Out of 576 patients, 10% received temporary closure, mainly due to issues like hemodynamic instability and bowel viability checks.
  • Results indicated that while temporary closure wasn't linked to higher mortality rates, it significantly increased the risk of postoperative complications compared to primary closure.
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The laparotomy is a common surgical procedure with a wide range of indications. Ideally, once the goals of surgery were achieved, the incision edges could then be approximated and the abdomen primarily closed. However, in some circumstances, it may be impossible to achieve primary closure, and instead the abdomen is intentionally left open.

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Article Synopsis
  • The study investigates the effectiveness of two temporary abdominal closure techniques—skin-only closure (SC) and Bogota bag closure (BBC)—in achieving primary fascial closure (PFC) for patients with peritonitis or abdominal trauma.
  • Conducted at Hayatabad Medical Complex from January 2022 to July 2023, it involved a retrospective cross-sectional analysis of 193 patients, comparing outcomes based on different closure methods.
  • Results show 59% of patients had SC, but further details on the comparative success rates of SC and BBC in achieving PFC were highlighted as a focus of the analysis.
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Temporary abdominal closure in oncological patients: Surgical characteristics and implications.

J Surg Oncol

September 2024

Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil.

Article Synopsis
  • Temporary abdominal closure (TAC) is used in critically ill oncological patients to manage severe abdominal issues and protect abdominal contents, with a focus on minimizing damage during surgery.* -
  • A study of 47 patients revealed they mostly had gastrointestinal tumors, were generally in poor health, and had high rates of emergency surgical complications, particularly from fecal peritonitis.* -
  • Only a small number of patients (14.8%) achieved successful abdominal closure, and the in-hospital mortality rate was alarmingly high at 85.2%, indicating TAC's high-risk nature in this patient group.*
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Article Synopsis
  • - The study investigated the impact of Open Abdomen (OA) on mortality rates in patients with Acute Mesenteric Ischemia (AMI), concluding that OA is linked to higher mortality and longer ventilator support.
  • - Out of 5,514 cases analyzed, 32.6% underwent OA, with findings showing an increased odds ratio for mortality of 1.58, particularly in patients who did not have revascularization.
  • - The research suggests that while OA can lead to greater complications in AMI cases, careful consideration is needed for its application, especially since 10% of patients with primary closure faced the need for reoperation.
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Outcomes of Prolonged Open Abdomen in Children.

J Surg Res

June 2024

Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.

Article Synopsis
  • The study aimed to analyze the outcomes for pediatric patients who required open abdomen surgery due to various conditions that might lead to prolonged open abdomen (POA) and complications with abdominal wall closure.
  • Researchers conducted a retrospective review of patients under 18 from 2015 to 2022, focusing on those needing three or more surgeries before closure, and collected data on demographics and outcomes.
  • Results showed a high survival rate of 93%, with many patients achieving primary closure of the abdomen despite the challenges, indicating a need for improved management protocols in future cases.
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Article Synopsis
  • Negative pressure wound therapy (NPWT) is used in temporary abdominal closure for patients with traumatic or vascular conditions, but its effectiveness during intestinal anastomosis is debated.
  • A study analyzed 97 patients receiving NPWT from 2014 to 2018 to identify risk factors for anastomotic dehiscence, including gender and surgical practices.
  • The findings indicated that female patients, those with delayed fascial closure, those using vasopressors, and NPWT pressures over 110 mmHg had a higher risk of dehiscence.
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Article Synopsis
  • - This study aimed to create an animal model for open abdomen (OA) using different closure techniques in rats to mimic postoperative conditions.
  • - Three groups of male rats were compared: one with just polypropylene mesh, one with mesh and a patch, and one with mesh plus a sutured patch, with their survival rates and healing processes monitored over a week.
  • - The findings indicated that while survival rates were similar, the group with the mesh and patch showed better wound healing and overall condition, making it the best technique for simulating OA for research.
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Background: The open abdomen is an innovation that greatly improved surgical understanding of damage control, temporary abdominal closure, staged abdominal reconstruction, viscera and enteric fistula care, and abdominal wall reconstruction. This article provides an evidence-informed, expert, comprehensive narrative review of the open abdomen in trauma, acute care, and vascular and endovascular surgery.

Methods: A group of 12 international trauma, acute care, and vascular and endovascular surgery experts were invited to review current literature and important concepts surrounding the open abdomen.

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Acellular Fish Skin Graft Use in Open Abdomen Management.

Surg Technol Int

September 2023

Department of Preventive Medicine, School of Medicine, University of Rochester, Rochester, New York.

Introduction: Open abdomen (OA) management post damage control laparotomy (DCL) is common in complex abdominal trauma and intra-abdominal catastrophe (IAC). Use of polyglactin 910 mesh (VICRYL™, Johnson & Johnson, New Brunswick, New Jersey) to cover the intra-abdominal contents and wound vacuum-assisted closure (VAC) is current practice in the management of temporary abdominal closure (TAC). This may have complications and requires two to three weeks for granulations to be ready for skin grafting.

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Long-term follow-up of temporary abdominal closure in complex abdomens during liver transplant.

Surgery

October 2023

Cincinnati Research in Outcomes and Safety in Surgery Research Group, Department of Surgery, University of Cincinnati College of Medicine, OH; Division of Transplantation, Department of Surgery, University of Cincinnati College of Medicine, OH. Electronic address:

Article Synopsis
  • The study assesses the long-term survival and outcomes of liver transplant patients who required temporary abdominal closure versus those who had primary fascial closure, using data from 2013 to 2017 with a 5-year follow-up.
  • Among 436 liver transplants, 17.2% needed temporary closure, which was associated with higher preoperative sickness (like higher MELD scores and more dialysis), and these patients also experienced longer hospital stays and higher readmission rates within 30 days.
  • While initial 1-year survival rates were lower for those with temporary closure (82.7% vs 90.9%), 5-year survival rates were not significantly different, indicating that temporary closure is a safe alternative with comparable long-term
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Article Synopsis
  • Damage-control surgery (DCS) is a method used to manage unstable surgical patients by postponing full repairs until their health stabilizes, emphasizing "physiology over anatomy."
  • Initially applied to trauma cases, DCS is now also used for non-traumatic abdominal emergencies, proving effective despite some controversy.
  • The discussion on DCS will cover its history, indications in emergency general surgery, phases of the procedure, and key strategies for patient management, including preoperative care and effective closure techniques.
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Article Synopsis
  • The study examines the impact of different temporary abdominal closure (TAC) methods on trauma patient outcomes, noting that previous research on this topic was difficult to compare due to varied data.
  • Researchers reviewed multiple studies, analyzing techniques like negative-pressure wound therapy and skin-only closures, focusing on outcomes such as mortality rates and complication incidences.
  • Results showed that vacuum closure had the lowest mortality rates (13%) and better overall outcomes, while skin-only closure had the highest mortality (35%), indicating that dynamic therapy generally outperformed static therapy across all measured endpoints.
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Article Synopsis
  • - The study analyzed ten years of experience with open abdomen techniques in trauma surgery, comparing a dual closure method called vacuum-assisted, mesh-mediated fascial traction (VAMMFT) to the traditional Bogota Bag (BB) method.
  • - Of 348 patients needing open abdomen management, VAMMFT had a higher closure success rate (73%) compared to BB (54.9%), but both methods had no significant differences in complications like fistulation.
  • - VAMMFT was found to be an effective and safe approach, leading to better closure rates while maintaining a low rate of complications, although failures were attributed mainly to supply issues and protocol violations.
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Article Synopsis
  • Hepatic arterioportal fistula (HAPF) is a rare complication that can arise from liver trauma, leading to symptoms like abdominal pain and portal hypertension over time.
  • This study analyzed 127 patients with severe liver injuries and identified 5 cases of acute HAPF requiring various surgical interventions, including angiography and embolization techniques.
  • Successful management of HAPF was achieved through modern endovascular methods, highlighting the importance of a multidisciplinary approach for optimal care in trauma situations.
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Article Synopsis
  • * Key findings showed that the average age of patients was 63 years, with differences in indications for OA and preferred closure techniques among the continents, particularly with higher use of certain methods in America and Europe versus Asia.
  • * The results indicate a significant variation in morbidity and mortality rates across continents, highlighting a lack of uniformity in OA management and adherence to international guidelines, which affects clinical outcomes.
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Article Synopsis
  • - The study evaluated the effectiveness and cost of two temporary abdominal closure (TAC) methods—ABTHERA Negative Pressure Therapy and whipstitch suture closure (WC)—for managing open abdomen in trauma patients from 2015 to 2021.
  • - A total of 112 patients were analyzed, with most experiencing blunt trauma; overall outcomes (like length of stay, complications) showed no significant differences between the two TAC methods.
  • - The findings suggest that WC is a cost-effective TAC option, providing similar clinical outcomes compared to the more expensive ABTHERA system.
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Objective: To evaluate the open abdomen technique (laparostomy) used in complications of major gynecological oncology surgery.

Methods: We analyzed retrospectively the surgical database of all patients who had undergone major open surgery by the same gynecologic oncologist over a 5-year period. All patients who had had open abdomen procedure were identified; demographic data and indications of primary surgery, temporary abdominal closure procedure details, fascia closure and morbidity, mortality rates were evaluated.

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Objectives: In conditions such as large-for-size syndrome, postreperfusion hepatic edema, and intestinal edema, primary closure of the abdominal wall can cause respiratory complications and thrombosis of vascular structures. Here, we compared results of primary abdominal closure versus a temporary patch closure technique (the Bogota bag technique) in pediatric liver transplant recipients.

Materials And Methods: We performed primary abdominal closure in 295 recipients.

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