Management of open abdominal wounds with a dynamic fascial closure system.
Management of open abdominal wounds with a dynamic fascial closure system.
复制标题
使用动态筋膜闭合系统处理开放性腹部伤口。
DOI：
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复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
M. Bell
中科院分区：
文献类型：
--
作者：
M. Reimer;J. Yelle;B. Reitsma;G. Doumit;M. Allen;M. Bell
背景
在损伤控制性手术中，在剖腹手术后的几天或几周内，直到患者稳定下来，才可能进行明确的腹部闭合。
方法
我们介绍了23例使用Canica ABRA动态伤口闭合系统治疗的患者，该系统使用经筋膜放置在伤口上的硅橡胶弹性体重新对合开放性晶状体。本研究旨在评估使用该系统的结果，并确定闭合不成功的风险因素。该系统在整个伤口上保持向内侧的力。进行了传统的伤口敷料更换方案。
结果
动态闭合系统平均保持48天，并在开放性腹部伤口治疗开始后平均18天应用。23例患者中有14例（61%）实现了延迟一期筋膜闭合，无需进一步手术。6名患者（26%）因腹壁疝愈合，但腹部缺损较小。两名患者（9%）通过伤口发生肠外瘘，需要进一步手术。伤口面积总体减少95%。
结论
这种动态伤口闭合技术允许61%的病例在初次剖腹手术后平均18天开始治疗时延迟一期闭合开放性阑尾。
BACKGROUND
In damage-control surgery, definitive abdominal closure may not be possible for several days or weeks after laparotomy until the patient has stabilized.
METHODS
We present 23 patients treated with the Canica ABRA dynamic wound closure system that re-approximated open abdomens with silicone elastomers placed transfascially across the wound. This study aimed to assess the results of using this system and to identify risk factors for unsuccessful closure. The system maintains a medially directed force across the wound. A traditional regimen of wound dressing changes was performed.
RESULTS
The dynamic closure system remained in place an average of 48 days and was applied an average of 18 days after the beginning of treatment for the open abdominal wound. Delayed primary fascial closure was achieved in 14 of 23 patients (61%) without further surgery. Six patients (26%) healed with ventral hernias but with a smaller abdominal defect. Two patients (9%) developed enterocutaneous fistulae through the wound that required further surgery. An overall reduction in wound area of 95% was achieved.
CONCLUSION
This dynamic wound closure technique permitted the delayed primary closure of open abdomens in 61% of cases when treatment was instituted an average of 18 days after initial laparotomy.
DOI：
10.1152/ajpheart.2000.279.1.h293
发表时间：
2000-07-01
影响因子：
4.8
作者：
Albuquerque, MLC;Waters, CM;Flozak, AS
通讯作者：
Flozak, AS