Serial abdominal closure with Gore-tex mesh and Rives-Stoppa for an open abdomen secondary to intra-abdominal hypertension in burns

ABSTRACT

Intra-abdominal hypertension (IAH) leading to abdominal compartment syndrome (ACS) commonly occurs in major burns. To relieve the excess pressure, decompressive laparotomy is done which can lead to an open abdomen. Closure of the abdomen after a decompressive laparotomy is very difficult with bowel oedema. We describe our technique of closing the open abdomen in such situations with a combination of serial abdominal wall closure with a layered mesh and the Rives-Stoppa component separation technique.

KEY WORDS

Abdominal compartment syndrome - abdominal hypertension - bogota - burn abdomen - component separation - goretex mesh - Intra-abdominal hypertension - mesh repair - open abdomen - postburn - Rives-Stoppa - PTFE mesh - polytetrafluoroethylene

• REFERENCES

• 1 Vertrees A, Kellicut D, Ottman S, Peoples G, Shriver C. Early definitive abdominal closure using serial closure technique on injured soldiers returning from Afghanistan and Iraq. J Am Coll Surg 2006; 202: 762-72
• 2 Ivy ME, Atweh NA, Palmer J, Possenti PP, Pineau M, D'Aiuto M. et al. Intra-abdominal hypertension and abdominal compartment syndrome in burn patients. J Trauma 2000; 49: 387-91
• 3 Papavramidis TS, Marinis AD, Pliakos I, Kesisoglou I, Papavramidou N. Abdominal compartment syndrome – Intra-abdominal hypertension: Defining, diagnosing, and managing. J Emerg Trauma Shock 2011; 4: 279-91
• 4 Coccolini F, Roberts D, Ansaloni L, Ivatury R, Gamberini E, Kluger Y. et al. The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 2018; 13: 7
• 5 Maerz L, Kaplan LJ. Abdominal compartment syndrome. Crit Care Med 2008; 36: S212-5
• 6 Boele van HensbroekP, Wind J, Dijkgraaf MG, Busch OR, Goslings JC. Temporary closure of the open abdomen: A systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg 2009; 33: 199-207
• 7 Koniaris LG, Hendrickson RJ, Drugas G, Abt P, Schoeniger LO. Dynamic retention: A technique for closure of the complex abdomen in critically ill patients. Arch Surg 2001; 136: 1359-62
• 8 Tieu BH, Cho SD, Luem N, Riha G, Mayberry J, Schreiber MA. et al. The use of the Wittmann patch facilitates a high rate of fascial closure in severely injured trauma patients and critically ill emergency surgery patients. J Trauma 2008; 65: 865-70
• 9 Kirshtein B, Roy-Shapira A, Lantsberg L, Mizrahi S. Use of the “Bogota bag” for temporary abdominal closure in patients with secondary peritonitis. Am Surg 2007; 73: 249-52
• 10 Forte A, Zullino A, Manfredelli S, Montalto G, Covotta F, Pastore P. et al. Rives technique is the gold stardard for incisional hernioplasty. An institutional experience. Ann Ital Chir 2011; 82: 313-7