Inverting bilateral figure-of-eight suture of the rectus sheath after burst abdomen with destruction of the linea alba: A new technique

Dietz, Ulrich; Debus, Eike Sebastian; Thiede, A.; Kuhfuß, I.

doi:10.1016/j.bjps.2005.11.044

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…In unfavorable fascial conditions, the rectus sheath layers were closed with bilateral inverted figure-eight sutures [17]. A third patient group was closed in a manner different from that described above (Table 1) (Fig.…”

Section: Methodsmentioning

confidence: 99%

Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia

Dietz

Wichelmann

Wunder

et al. 2012

Hernia

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PurposeOnce open abdomen therapy has succeeded, the problem of closing the abdominal wall must be addressed. We present a new four-stage procedure involving the application of a two-component mesh and vacuum conditioning for abdominal wall closure of even large defects. The aim is to prevent the development of a giant ventral hernia and the eventual need for the repair of the abdominal wall.MethodsNineteen of 62 patients treated by open abdomen over a two-year period could not receive primary abdominal wall closure. To achieve closure in these patients, we applied the following four-stage procedure: stage 1: abdominal damage control and conditioning of the abdominal wall; stage 2: attachment of a tailored two-component mesh of polyglycolic acid (PGA) and large pore polypropylene (PP) in intraperitoneal position (IPOM) plus placement of a vacuum bandage; stage 3: vacuum therapy for 3–4 weeks to allow granulation of the mesh and optimization of dermatotraction; stage 4: final skin suture. During stage 3, eligible patients were weaned from respirator and mobilized.ResultsThe abdominal wall gap in the 19 patients ranged in size from 240 cm2 to more than 900 cm2. An average of 3.44 vacuum dressing changes over 19 days were required to achieve 60–100 % granulation of the surface area, so final skin suture could be made. Already in stage 3, 14 patients (73.68 %) could be weaned from respirator an average of 6.78 days after placement of the two-component mesh; 6 patients (31.57 %) could be mobilized on the edge of the bed and/or to a bedside chair after an average of 13 days. No mesh-related hematomas, seromas, or intestinal fistulas were observed.ConclusionThe four-stage procedure presented here is a viable option for achieving abdominal wall closure in patients treated with open abdomen, enabling us to avoid the development of planned giant ventral hernias. It has few complications and has the special advantage of allowing mobilization of the patients before final skin closure. Long-term course in a large number of patients must still confirm this result.

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Section: Methodsmentioning

confidence: 99%

Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia

Dietz

Wichelmann

Wunder

et al. 2012

Hernia

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“…8 Many new techniques have been developed in a hope to prevent or reduce the risk of fascial dehiscence, but burst abdomen remains an unavoidable morbidity. 9 Also, in recent large multicenter trials surgeons at various institutions showed lack of consensus regarding optimal technique for midline abdominal incision closure in emergency laparotomies. 4 The aim of this study was to determine the superior https://doi.org/10.29309/TPMJ/2021.28.04.6020 technique for midline abdominal incisions closure in emergency laparotomy patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcome of interrupted versus continuous closure technique of rectus sheath in emergency laparotomies patients in terms of wound dehiscence.

Ullah

Uddin²,

Shoib

et al. 2021

TPMJ

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Objective: To compare outcome of interrupted versus continuous closure of rectus sheath in emergency laparotomy patients, in terms of wound dehiscence. Study Design: Randomized Controlled Trail. Setting: Department of Casualty Surgical Pir Abdul Qadir Shah Institute of Medical Sciences, Gambat. Period: 1st January to 30th June 2020. Material & Methods: Total duration of study was 6 months. Total of 150 patients (75 in each group) were studied. Interrupted closure of rectus sheath was done in group “A” patients while continuous closure was done in group “B” patients, and efficacy in terms of wound dehiscence was compared in both groups. Results: Overall male to female ratio was1.29:1. The average age of the patients was 39.41 years +13.02SD. Wound dehiscence in Group “A” was found in 2.6% cases while 6.6% in Group “B” patients. Conclusion: Interrupted closure of Rectus sheath in emergency laparotomy is more effective than continuous closure in preventing wound dehiscence.

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“…The advent of prosthetic materials, meshes of the most diverse compositions, was key in improving the technical outcomes of the surgical repair of congenital or acquired abdominal wall defects. Its utilization, compared with the simple rhaphy of the aponeurotic defect, reduced the recurrence rates of hernias considerably [2][3][4][5][6][7][8] . The polypropylene mesh is the most commonly used material [2][3][4]6,[9][10][11][12] .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…Its utilization, compared with the simple rhaphy of the aponeurotic defect, reduced the recurrence rates of hernias considerably [2][3][4][5][6][7][8] . The polypropylene mesh is the most commonly used material [2][3][4]6,[9][10][11][12] . The intra-abdominal use of meshes, however, has restricted indications, since their intraperitoneal placement brings forth complications as it may be associated with the formation of adhesions, enterocutaneous fistulae 6,7,[13][14][15][16][17] and Araújo …”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Reparo intraperitoneal de defeitos da parede ventral do abdome com telas de poliéster com colágeno e polipropileno com ácido poliglicólico

Araújo

Czeczko

Ribas-Filho

et al. 2009

Rev. Col. Bras. Cir.

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OBJETIVO: Avaliar a incorporação de telas de poliéster revestido em uma de suas faces por colágeno (Parietex, Covidien) e polipropileno recoberto por ácido poliglicólico (Optilene Mesh Elastic e Safil, BBD Aesculap) no reparo de defeitos da parede ventral de coelhos avaliando a cicatrização no aspecto macroscópico, o depósito de colágeno e a imunomarcação tecidual pelos anticorpos MMP-1, MMP-8 e MMP-13. MÉTODOS: Utilizaram-se 16 coelhos, divididos em dois grupos de oito animais, avaliados após eutanásia após 30 e 60 dias de pós-operatório. Os animais foram submetidos à realização de dois defeitos simétricos na parede ventral do abdome, à direita e esquerda da linha alba, que compreendendo todos os folhetos musculares e o peritônio. O reparo dos defeitos foi realizado mediante implante intraperitoneal de dois modelos diferentes de telas. Utilizou-se a tela de poliéster revestido com camada protetora de colágeno (grupo controle) e a tela de polipropilene revestido com malha de ácido poliglicólico (manufaturacao própria, grupo de experimentacao). A avaliacao constou de aspectos clínicos, achados macroscópicos, análise dos colágenos tipos I/III e avaliação imunoistoquímica de metaloproteinases. RESULTADOS: Os resultados da avaliacao clínica e os parâmetros macroscópicos foram semelhantes entre os grupos. 50% dos animais do grupo Parietex tiveram ausência de aderencias intraperitoneais a no 30° dia de pós-operatrório. Em ambos os grupos observou-se reducao das aderências entre o 30° e o 60° dias de pós-operatório, contudo sem diferenca estatística. As aderências observadas foram classificadas principalmente de frouxas. Nao se observou a ocorrencia de complicacoes envolvendo vísceras intraabdominais. No Grupo Parietex houve a ocorrência de formacao de ulceracao da pele que recobria a tela em quatro animais, em comparacao com um no grupo de experimentacao. No Grupo Parietex foi observada uma insuficiencia de reparo após 60 dias. Quanto ao depósito do colágeno tipos I e III, nao houve diferenca significativa entre os grupos. Os resultados da imunoistoquímica referentes aos anticorpos MMP-1 e MMP-8 também não demonstraram diferença significativa entre as telas. CONCLUSÃO: As duas telas pesquisadas obtiveram resultados semelhantes tanto nos aspectos macro como nos microscópicos, podendo ser consideradas semelhantes quanto ao reparo de defeitos cirúrgicos da parede ventral do abdome em coelhos.

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Inverting bilateral figure-of-eight suture of the rectus sheath after burst abdomen with destruction of the linea alba: A new technique

Cited by 8 publications

References 12 publications

Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia

Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia

Comparison of outcome of interrupted versus continuous closure technique of rectus sheath in emergency laparotomies patients in terms of wound dehiscence.

Reparo intraperitoneal de defeitos da parede ventral do abdome com telas de poliéster com colágeno e polipropileno com ácido poliglicólico

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