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Hernia
Published in: Hernia 5/2017

01-10-2017 | How-I-Do-It

Simple and safe technique for closure of midline abdominal wound dehiscence

Author: M. H. Abo-Ryia

Published in: Hernia | Issue 5/2017

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Abstract

Purpose

The aim of this study was to assess an alternative technique for closure of burst abdomen.

Method

After reduction of the viscera and toilet of abdominal cavity with debridement of any necrotic tissues in the skin or fascia, the skin was undermined to expose the aponeurosis all-around the defect edges for at least 5–6 cm. The greater omentum is spread in the floor of the wound and fixed to the inner side of the defect. A piece of polypropylene mesh designed according to the size and shape of the defect and sutured to its external edge continuously. Another larger mesh is placed to cover the smaller one and extend over the aponeurosis exceeding the defect edges by at least 5–6 cm and fixed to it.

Results

Six males and five females were included. Mean age was 49.3 year. Mean follow-up period was 17.8 months. Wound infection occurred in 5 patients (45.4%). Mean hospital stay was 18.7 days. No patients developed abdominal compartment syndrome, recurrence or intestinal fistula. No mortality was reported. Two cases developed mild local bulge.

Conclusion

This technique provides a simple, safe and effective alternative in the treatment of burst abdomen.
Literature
1.
Abbott DE, Dumanian GA, Halverson AL (2007) Management of laparotomy wound dehiscence. Am Surg 73(12):1224–1227PubMed
2.
Swaroop M, Williams M, Greene WR, Sava J, Park K, Wang D (2005) Multiple laparotomies are a predictor of fascial dehiscence in the setting of severe trauma. Am Surg 71:402–405PubMed
3.
Pavlidis TE, Galatianos IN, Papaziogas BT, Lazaridis CN, Atmatzidis KS, Makris JG et al (2001) Complete dehiscence of the abdominal wound and incriminating factors. Eur J Surg 167:351–354CrossRefPubMed
4.
Poole GV (1985) Mechanical factors in abdominal wound closure: the prevention of fascial dehiscence. Surgery 97:631–640PubMed
5.
Van’t Riet M, Vos De, van Steenwijk PJ, Bonjer HJ, Steyerberg EW, Jeekel J (2004) Incisional hernia after repair of wound dehiscence: incidence and risk factors. Am Surg 70:281–286PubMed
6.
Van Geldere D (2000) One hundred years of abdominal wound dehiscence and nothing has changed. Hernia 4:302–304CrossRef
7.
Van Ramshorst GH, Eker HH, Harlaar JJ, Nijens KJ, Jeekel J, Lange JF (2010) Therapeutic alternatives for burst abdomen. Surg Technol Int 19:111–119PubMed
8.
Amini AQ, Khan NA, Ahmad J, Memon AS (2013) Management of abdominal wound dehiscence: still a challenge. Pak J Surg 29(2):84–87
9.
Subramonia S, Pankhurst S, Rowlands BJ, Lobo DN (2009) Vacuum-assisted closure of postoperative abdominal wounds: a prospective study. World J Surg 33:931–937CrossRefPubMed
10.
Gislason H, Viste A (1999) Closure of burst abdomen after major gastrointestinal operations-comparison of different surgical techniques and later development of incisional hernia. Eur J Surg 165(10):958–961CrossRefPubMed
11.
Rink AD, Goldschmidt D, Dietrich J, Nagelschmidt M, Vestweber KH (2000) Negative side-effects of retention sutures for abdominal wound closure. A prospective randomized study. Eur J Surg 166(12):932–937CrossRefPubMed
12.
Qassemyar Q, Browet F, Robbe M et al (2011) Dynamic parietal closure: initial experience of an original parietal closure procedure for treatment of abdominal wound dehiscence. Arch Surg 146(6):762–764CrossRefPubMed
13.
Salman AE, Yetis F, Aksoy M, Tokac M, Yildirim MB, Kilic M (2014) Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen. Hernia 18:99–104CrossRefPubMed
14.
Buck JR, Fath JJ, Chung SK, Sorensen VJ, Horst HM, Obeid FN (1995) Use of absorbable mesh as an aid in abdominal wall closure in the emergent setting. Am Surg 61(8):655–657PubMed
15.
Van’t Riet M, de Vos van Steenwijk PJ, Bonjer HJ, Steyerberg EW, Jeekel J (2007) Mesh repair for postoperative wound dehiscence in the presence of infection: is absorbable mesh safer than non-absorbable mesh? Hernia 11:409–413CrossRefPubMed
16.
López Cano M, Armengol Carrasco M, Quiles Pérez MT, Arbós Vía MA (2013) Biological implants in abdominal wall hernia surgery. Cir Esp 91:217–223CrossRefPubMed
17.
Platell C, Cooper D, Papadimitriou JM, Hall JC (2000) The omentum. World J Gastroentero 6(2):169–176
18.
Sorour MA (2014) Interposition of the omentum and/or the peritoneum in the emergency repair of large ventral hernias with polypropylene mesh. IJS 12:578–586
19.
Munoz Munoz E, Pardo Aranda F, Camps Lasa J, Rodriguez Alsina X, Veloso Veloso E (2015) Repair of large abdominal wall defects by epiploplasty and polypropelene mesh in patients with decompressive laparostomies. Cir Esp 93:204–206CrossRefPubMed
Metadata
Title
Simple and safe technique for closure of midline abdominal wound dehiscence
Author
M. H. Abo-Ryia
Publication date
01-10-2017
Publisher
Springer Paris
Published in
Hernia / Issue 5/2017
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-017-1589-8

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