Federico Coccolini - Open Abdomen: A Comprehensive Practical Manual
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- Book:Open Abdomen: A Comprehensive Practical Manual
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This book is the first available practical manual on the open abdomen. Practicing physicians, surgeons, anesthesiologists, nurses, and physiotherapists will find in it a ready source of information on all aspects of open abdomen management in a wide variety of settings. The coverage includes, for example, the open abdomen in trauma, intra-abdominal sepsis, and acute pancreatitis, step-by-step descriptions of different techniques with the aid of high-quality color figures, guidance on potential complications and their management, and features of management in different age groups. The book contents illustrate the most recent innovations and drawing upon a thorough and up-to-date literature review. Useful tips and tricks are highlighted, and the book is designed to support in daily decision making. The authors include worldwide opinion leaders in the field, guaranteeing the high scientific value of the content.
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Author, year | Indication for OAM | Results | Comments |
|---|---|---|---|
Ogilvie, 1940 | Temporary closure of abdominal war wounds with too much tension to close primarily | Double sheet of light canvas or stout cotton cut rather smaller than the defect in the muscles and sutured into place with interrupted catgut sutures Vaseline-impregnated gauze rolls over exposed viscera and closure of wound over them with strips of Elastoplast or stitches | |
Ogilvie, 1945 | Leave the abdomen open and close it secondarily after 14 days | ||
Steinberg, 1979 | Fourteen patients with acute generalized peritonitis, the abdomen was left open after the first laparotomy by gauze packs on the viscera. Abdominal wires were placed to be tied to close the abdomen after 4872 h | Mortality 7% | Treat the infected abdomen just as an abscess |
Duff and Moffat, 1981 | Abdominal sepsis, necrotizing wound infection | 39% mortality | Abdominal closure by STSG/skin sutures |
Mughal, 1986 | Fourteen patients: GI perforations/anastomotic dehiscence (n-11), recurrent pancreatic abscess ( n = 3) | 28% mortality | OAM termed laparostomy |
Hedderich, 1986 | Ten patients with abdominal sepsis and fecal peritonitis (3), radiation enteritis with fistula (1), diverticular abscess (1), diffuse post-op sepsis (2), necrotizing pancreatitis (3) | 20% mortality | Marlex mesh with zipper |
Schein, 1988 | Nine with diffuse peritonitis | 32% mortality | Average seven reoperations per patient! |
Mastboom, 1989 | Fourteen with 53 small bowel fistulas from OAM | 64% mortality | A detailed description of this dreadful complication after OAM |
Garcia-Sabrido, 1989 | Forty-nine with necrotic pancreatitis Fifteen with severe intra-abdominal sepsis | Intra-abdominal sepsis: (in 26.5%) mortality (expected 45%), pancreatic necrosis (6%, single abscess, 9, 22% infected pancreatic necrosis (expected 47%) | Quantification of severity of illness by APACHE II |
Ivatury, 1989 | Thirty patients with abdominal sepsis (11 patients after trauma [group 1], 5 pancreatic abscess [group 2], 14 acute GI pathology [group 3]) | Mortality 27% in group 1, 40% in group 2, and 64% in group 3 | Survival: age < 50 years and the absence of multiple organ failure Quantification of severity of illness by APACHE II Absorbable mesh for TAC |
Ivatury, 1990 | 13 with post-trauma abdominal sepsis, 11 with MOF | Mortality 23% | APACHE II scoring, absorbable mesh for TAC |
Whitmann, 1990 | One hundred and seventeen treated by Etappen lavage | APACHE II scoring Actual mortality 25% (expected mortality 47%) | TAC retention sutures ( n = 45), a simple zipper ( n = 26), a slide fastener ( n = 29), and Velcro analogue ( n = 17) |
Christou, 1993 | Two hundred and thirty-nine patients with surgical abdominal infection in a prospective, open, consecutive, nonrandomized trial | Closed abdomen technique: 31% mortality versus 44% open abdomen | Surgical Infection Society study |
Author, year | Indication for OAM | Comments |
|---|---|---|
Burch, 1992 | Abbreviated laparotomy | Multiple towel clip closure of abdominal incision, not truly an OAM technique |
Morris, 1993 | Staged celiotomy for trauma | Rapid closure of the abdomen in phase 1. Decompressive laparotomy for ACS. Not truly an OAM technique. ACS is diagnosed when fully developed |
Rotondo, 1993 | Damage control (DC): first use and description of term | Rapid closure of the abdomen. Not truly an OAM technique, no mention of IAP measurement |
Meldrum, 1997 | Twenty-one (14%) of 145 patients (ISS > 15) requiring laparotomy developed ACS; 24% were planned decompression. The remaining were prompted by deteriorating organ function from ACS | Not truly an OAM technique. ACS is diagnosed only when fully developed Proposed ACS grading system for selective management of the syndrome |
Ivatury, 1997 | State-of-the-art review article | Emphasis on IAP measurement, IAH as a precursor of ACS, surgical intervention at the stage of IAH and not wait until full-blown ACS Among the first to propose non-closure of fascia, OAM with fascial prosthesis as prophylaxis for IAH in high-risk patients |
Mayberry, 1997 | Group 1 consisted of 47 patients who received mesh at initial celiotomy, and group 2, 26 patients who received mesh at a subsequent celiotomy. Groups were statistically similar in demographics, injury severity, and mortality. Group 2 had a significantly higher incidence of postoperative abdominal compartment syndrome (35 versus 0%), necrotizing fasciitis (39 versus 0%), intra-abdominal abscess/peritonitis (35 versus 4%), and enterocutaneous fistula (23 versus 11%) compared with group 1 ( p < 0.001) |
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