The effect of different temporary abdominal closure techniques on fascial wound healing and postoperative adhesions in experimental secondary peritonitis

Aydın, Çiğdem; Aytekin, Faruk Önder; Yenisey, Çiğdem; Kabay, Burhan; Erdem, Ergün; Kocbil, Goksel; Tekin, Koray

doi:10.1007/s00423-007-0189-y

Cited by 14 publications

(9 citation statements)

References 31 publications

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“…A recent study on adhesion formation resulting from abdominal closure techniques showed that the use of Bogota bags increased adhesion formation [29], although none of the PVC cover groups in the present study showed an increase in adhesion. This may be explained by the fact that their model already had peritonitis, a condition that drastically alters the process of wound healing.…”

Section: Discussioncontrasting

confidence: 49%

Comparison between the Intraoperative Use of Polyvinyl Chloride Cover and Surgical Compresses for Preventing Postoperative Adhesions

Akyol¹,

Sozener²,

Ozgun³

et al. 2013

Eur Surg Res

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Background/Purpose: Surgical compresses used for retraction during major abdominal and pelvic procedures lead to postoperative adhesion formation resulting from damage to the visceral peritoneum. This study investigates whether polyvinyl chloride (PVC) covers cause less postsurgical adhesion and inflammation than surgical compresses in an animal model. Methods: Female Wistar albino rats (n = 160) were divided into three groups (compress, PVC cover and control), which were then divided into 16 subgroups (n = 10/group). All animals underwent midline laparotomy and cecal abrasion. A metal retractor, which applies a constant force, was then placed on the small intestine for 2 h. In the control group, no material was placed under the retractor, whereas a surgical compress or PVC cover was placed in the experimental animals. Full-thickness small intestinal biopsies were obtained and examined by light and electron microscopy. The following parameters were evaluated: congestion, mesothelial proliferation, leukocyte migration and collagenization. Adhesions were scored according to the Nair, Knightly and Mazuji scoring systems. Results: All inflammation scores were significantly higher in the compress group than in the other two groups. However, no significant difference was observed between the PVC cover and control groups. Adhesions were more frequent in the compress group than in the other two groups, regardless of the scoring system used. Conclusions: Surgical compresses used in abdominal and pelvic surgeries cause inflammation and adhesion. Contrary to surgical compresses, PVC covers do not cause inflammation and adhesion, which may considerably reduce adhesion-related complications in abdominopelvic surgeries.

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Section: Discussioncontrasting

confidence: 49%

Comparison between the Intraoperative Use of Polyvinyl Chloride Cover and Surgical Compresses for Preventing Postoperative Adhesions

Akyol¹,

Sozener²,

Ozgun³

et al. 2013

Eur Surg Res

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“…The Bogota Bag does not allow the effective removal of excessive fluid in bowel oedema or of toxin and cytokine‐rich intra‐abdominal fluid. In addition, this technique does not prevent the loss of abdominal wall domain (Figure 1B) (14,15).…”

Section: Methods For Temporary Abdominal Wall Closurementioning

confidence: 98%

Total management of the open abdomen

Δημητριάδης

2012

International Wound Journal

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The management of complex abdominal problems with the 'open abdomen' (OA) technique has become a routine procedure in surgery. The number of cases treated with an OA has increased dramatically because of the popularisation of damage control for life-threatening conditions, recognition and treatment of intra-abdominal hypertension and abdominal compartment syndrome and new evidence regarding the management of severe intra-abdominal sepsis. Although OA has saved numerous lives and has addressed many problems related to the primary pathology, this technique is also associated with serious complications. New knowledge about the pathophysiology of the OA and the development of new technologies for temporary abdominal wall closure (e.g. ABThera™ Open Abdomen Negative Pressure Therapy; KCI USA Inc., San Antonio, TX) has helped improve the management and outcomes of these patients. This review will merge expert physician opinion with scientific evidence regarding the total management of the OA.

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“…The optimal TAC strategy should prevent evisceration, evacuate fluid, allow access to the abdominal cavity, and allow for expansion in order to prevent abdominal compartment syndrome (ACS) [2-4]. The second stage of DCL involves continuation of resuscitation, which should include judicious fluid administration with aggressive correction of coagulopathy, acidosis, and hypothermia.…”

Section: Introductionmentioning

confidence: 99%

Abdominal damage control surgery and reconstruction: world society of emergency surgery position paper

et al. 2013

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Damage control laparotomy was first described by Dr. Harlan Stone in 1983 when he suggested that patients with severe trauma should have their primary procedures abbreviated when coagulopathy was encountered. He recommended temporizing patients with abdominal packing and temporary closure to allow restoration of normal physiology prior to returning to the operating room for definitive repair. The term damage control in the trauma setting was coined by Rotondo et al., in 1993. Studies in subsequent years have validated this technique by demonstrating decreased mortality and immediate post-operative complications. The indications for damage control laparotomy have evolved to encompass abdominal compartment syndrome, abdominal sepsis, vascular and acute care surgery cases. The perioperative critical care provided to these patients, including sedation, paralysis, nutrition, and fluid management strategies may improve closure rates and recovery. In the rare cases of inability to primarily close the abdomen, there are a number of reconstructive strategies that may be used in the acute and chronic phases of abdominal closure.

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The effect of different temporary abdominal closure techniques on fascial wound healing and postoperative adhesions in experimental secondary peritonitis

Cited by 14 publications

References 31 publications

Comparison between the Intraoperative Use of Polyvinyl Chloride Cover and Surgical Compresses for Preventing Postoperative Adhesions

Comparison between the Intraoperative Use of Polyvinyl Chloride Cover and Surgical Compresses for Preventing Postoperative Adhesions

Total management of the open abdomen

Abdominal damage control surgery and reconstruction: world society of emergency surgery position paper

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