Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique
Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique
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DOI：
10.1002/bjs.4101
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发表时间：
2003-06-01
影响因子：
9.6
通讯作者：
Kahn, D
中科院分区：
文献类型：
--
作者：
Navsaria, PH;Bunting, M;Kahn, D
背景：本文介绍了一种改良的三明治真空包装技术的5年经验，使用打开的3升泌尿冲洗袋和持续高压吸引，用于临时腹壁闭合。方法：对1996年1月至2000年12月间采用该方法行临时腹壁闭合术的患者资料进行分析。结果：55例患者使用改良夹层真空包装139次。40例为穿透性创伤，15例为钝性创伤。平均损伤严重程度评分为19（范围9-34）。腹内败血症（51%）是最常见的适应症，其次是内脏水肿（18%）、腹膜隔室综合征（16%）、腹内填塞（11%）和腹壁缺陷（4%）。总死亡率为45%。3名患者（5%）出现肠-皮瘘。在30名幸存者中，16名患者接受了初级筋膜闭合。结论：改良的夹层-真空包夹技术是一种简便、快速、经济的腹壁临时封闭技术，是一种有效的容纳腹壁内容物的方法。
Background: A 5-year experience with the modified sandwich-vacuum pack technique, using an opened 3-litre urological irrigation bag and continuous high-pressure suction, for temporary abdominal wall closure is presented.Methods: The records of all patients who underwent temporary abdominal wall closure using this method from January 1996 to December 2000 were examined.Results: The modified sandwich-vacuum pack was used 139 times in 55 patients. Forty patients sustained penetrating trauma while 15 patients sustained blunt trauma. The mean Injury Severity Score was 19 (range 9-34). Intra-abdominal sepsis (51 per cent) was the commonest indication, followed by visceral oedema (18 per cent), abdominal compartment syndrome (16 per cent), intra-abdominal packing (11 per cent) and abdominal wall defects (4 per cent). The overall mortality rate was 45 per cent. Three patients (5 per cent) developed enterocutaneous fistula. Of the 30 survivors, 16 patients underwent primary fascial closure.Conclusion: The modified sandwich-vacuum pack technique of temporary abdominal wall closure is easy and rapid, cost effective and provides an effective means of containing abdominal wall contents.