In Vitro Comparison of Intra-Abdominal Hypertension Development After Different Temporary Abdominal Closure Techniques

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p<0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

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Compartment Syndrome

10.2310/vasc.2194 ◽

2017 ◽

Author(s):

Basem Attum ◽

William Obremskey ◽

Bradley Dennis ◽

Richard Miller

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Clinical Signs ◽

Skin Closure ◽

Temporary Abdominal Closure ◽

Diagnosis And Management ◽

Abdominal Closure ◽

Decompressive Laparotomy ◽

Abdominal Hypertension ◽

Abdominal Compartment

Compartment syndrome is a process that can develop anywhere skeletal muscle or abdominal organs are encased by a rigid fascial layer. This review describes the different aspects of these conditions, including the epidemiology, pathophysiology, diagnosis, and management of compartment syndrome in the extremities and abdomen. Diagnosis is expanded on further to describe clinical signs in the alert patient and the different methods of compartment measurement in the obtunded patient or when a physical examination is inconclusive. The anatomy of the leg, thigh, buttocks, forearm, and arm is described, along with surgical techniques for fasciotomy. Postoperative care, the different methods of wound management and skin closure, and diagnostic criteria for the diagnosis and management of abdominal compartment syndrome are discussed. Treatment of abdominal compartment syndrome with decompressive laparotomy and temporary abdominal closure is also described. Figures depict various fasciotomies and an algorithmic approach to management. Tables show the contents and function of the compartments of the leg and forearm. Key words: abdominal compartment syndrome, compartment syndrome, decompressive laparotomy, extremity, fasciotomy, intra-abdominal hypertension, intra-abdominal pressure, temporary abdominal closure, tibia fracture

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Compartment Syndrome

10.2310/surg.2194 ◽

2017 ◽

Author(s):

Basem Attum ◽

William Obremskey ◽

Bradley Dennis ◽

Richard Miller

Keyword(s):

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Clinical Signs ◽

Skin Closure ◽

Temporary Abdominal Closure ◽

Diagnosis And Management ◽

Abdominal Closure ◽

Decompressive Laparotomy ◽

Abdominal Hypertension ◽

Abdominal Compartment

Compartment syndrome is a process that can develop anywhere skeletal muscle or abdominal organs are encased by a rigid fascial layer. This review describes the different aspects of these conditions, including the epidemiology, pathophysiology, diagnosis, and management of compartment syndrome in the extremities and abdomen. Diagnosis is expanded on further to describe clinical signs in the alert patient and the different methods of compartment measurement in the obtunded patient or when a physical examination is inconclusive. The anatomy of the leg, thigh, buttocks, forearm, and arm is described, along with surgical techniques for fasciotomy. Postoperative care, the different methods of wound management and skin closure, and diagnostic criteria for the diagnosis and management of abdominal compartment syndrome are discussed. Treatment of abdominal compartment syndrome with decompressive laparotomy and temporary abdominal closure is also described. Figures depict various fasciotomies and an algorithmic approach to management. Tables show the contents and function of the compartments of the leg and forearm. Key words: abdominal compartment syndrome, compartment syndrome, decompressive laparotomy, extremity, fasciotomy, intra-abdominal hypertension, intra-abdominal pressure, temporary abdominal closure, tibia fracture

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Overview on Temporary Abdominal Closure Techniques: A Review

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i57a33970 ◽

2021 ◽

pp. 68-74

Author(s):

Hashem Bark Awadh Abood ◽

Sadeel Fahad Daghistani ◽

Nouf Hashem Koshak ◽

Yazid Ali Alghamdi ◽

Sahad sami Ghamri ◽

...

Keyword(s):

Open Abdomen ◽

Fascial Closure ◽

Temporary Abdominal Closure ◽

Advantages And Disadvantages ◽

Abdominal Closure ◽

Abdominal Hypertension ◽

Fluid Regulation ◽

Abdominal Compartment ◽

Emergency Abdominal Surgery ◽

The Ideal

Open abdomen (OA) is becoming more common, primarily to prevent intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) following emergency abdominal surgery. The purpose of temporary abdominal closure (TAC) techniques is no longer just abdomen coverage; fluid regulation and early fascial closure are now important considerations. TAC techniques for leaving the abdomen open are numerous. The ideal one should be simple to apply and remove, allow for quick access to a surgical second opinion, drain secretions, ease primary closure with acceptable morbidity and mortality, allow for easy nursing, and, finally, be readily available and inexpensive. Over the years, several TAC methods have been proposed. In this review, we overview different techniques for temporary abdominal closure and its advantages and disadvantages.

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