Phase IV: Late Reconstruction Abdominal Wall Closure: Staged Management Technique
There has been an evolution in managing the laparotomy wound associated with devastating abdominal injuries over the past 25 years. The pathophysiology of the scenario resulting in intra-abdominal hypertension has been fairly well worked out in both laboratory models as well as in clinical observational studies. It has been observed that closure of the laparotomy incision under such circumstances results in a compartment syndrome. As an alternative to closure under tension, the development of multiple methods of open abdominal wound management has evolved. However, while this progress has positively influenced some of these problems, a new dilemma has emerged: the giant ventral hernia [1, 2, 3, 4, 5, 6].
KeywordsVentral Hernia Open Abdomen Abdominal Wall Defect Fascial Closure Abdominal Wall Reconstruction
Unable to display preview. Download preview PDF.
- 7.Ivatury RR, Porter JM, Simon RJ, Islam S, John R, Stahl WM. Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: Prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. J Trauma 1998; 44:1016–1023.CrossRefPubMedGoogle Scholar
- 17.Fabian TC, Croce MA, Pritchard FE, Minard G, Hickerson WL, Howell RL, Schurr MJ, Kudsk KA. Planned ventral hernia. Staged management for acute abdominal wall defects. Ann Surg 1994; 219:643–653.Google Scholar