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Open Abdomen pp 237-246 | Cite as

Definitive Closure, Long-Term Results, and Management of Ventral Hernia

  • Leonard Frederik Kroese
  • Johannes Jeekel
  • Johan Frederik Lange
Chapter
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)

Abstract

After treatment of open abdomen, large defects remain, often with loss of domain and without the possibility of tension-free closure. Loss of domain, in combination with other factors, increases the risk of complications after closure surgery.

To achieve definitive closure of the abdominal wall, advancement of the abdominal wall has to be performed with mesh placement. Possible techniques to gain advancement are Rives–Stoppa, anterior component separation (modified Ramirez), or posterior component separation (transverse abdominis release (TAR)).

When tension-free closure is still not possible, additional treatments like bridging with mesh, preoperative progressive pneumoperitoneum, and/or botulin toxin injections can be helpful.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Leonard Frederik Kroese
    • 1
  • Johannes Jeekel
    • 2
  • Johan Frederik Lange
    • 1
    • 3
  1. 1.Department of SurgeryErasmus University Medical Center RotterdamRotterdamThe Netherlands
  2. 2.Department of NeuroscienceErasmus University Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Department of SurgeryHavenziekenhuis RotterdamRotterdamThe Netherlands

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