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https://www.readbyqxmd.com/read/28936682/early-versus-delayed-source-control-in-open-abdomen-management-for-severe-intra-abdominal-infections-a-retrospective-analysis-on-111-cases
#1
Stefano Rausei, Vincenzo Pappalardo, Laura Ruspi, Antonio Colella, Simone Giudici, Vincenzo Ardita, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi
BACKGROUND: Time to source control plays a determinant prognostic role in patients having severe intra-abdominal infections (IAIs). Open abdomen (OA) management became an effective treatment option for peritonitis. Aim of this study was to analyze the correlation between time to source control and outcome in patients presenting with abdominal sepsis and treated by OA. METHODS: We retrospectively analyzed 111 patients affected by abdominal sepsis and treated with OA from May 2007 to May 2015...
September 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28878877/multiple-small-intestinal-perforations-in-a-patient-with-hepatitis-b-virus-associated-polyarteritis-nodosa
#2
Maria Isaia, Demetris Christou, Panayiotis Kallis, Panayiotis Georgiou, Nikolaos Nikolaou, Panayiotis Hadjicostas
We present the case of a 38-year-old patient with a history of Hepatitis B Virus-associated Polyarteritis Nodosa, who presented with acute abdomen and septic shock. The patient initially had three perforations of the small intestine that were treated with segmental enterectomy and anastomosis at two sites. During his postoperative course he continued to develop new perforations and necrotic lesions along the whole length of the small intestine, that mandated repetitive laparotomies and the technique of the open abdomen was employed...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28877534/open-abdomen-improves-survival-in-patients-with-peritonitis-secondary-to-acute-superior-mesenteric-artery-occlusion
#3
Weiwei Ding, Kai Wang, Baochen Liu, Xinxin Fan, Shikai Wang, Jianmin Cao, Xingjiang Wu, Jieshou Li
BACKGROUND: Damage control surgery and open abdomen (OA) have been extensively used in the severe traumatic patients. However, there was little information when extended to a nontrauma setting. The purpose of this study was to evaluate whether the liberal use of OA as a damage control surgery adjunct improved the clinical outcome in acute superior mesenteric artery occlusion patients. STUDY DESIGN: A single-center, retrospective cohort review was performed in a national tertiary surgical referral center...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28876621/the-absolute-number-of-repeat-operations-for-complex-intra-abdominal-sepsis-is-not-a-useful-predictor-of-non-survival
#4
M F Scriba, G L Laing, J L Bruce, D L Clarke
BACKGROUND: When multiple repeat laparotomies are required to manage intra-abdominal sepsis, questions about futility of treatment frequently arise. This study focuses specifically on patients who required two or more repeat laparotomies and describes the spectrum of disease necessitating multiple repeat laparotomies and the associated outcomes in the hope of clarifying the issue. METHOD: This study was conducted over a 20-month period (December 2012 - July 2014) at Greys Hospital in Pietermaritzburg, South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28831516/-management-of-traumatic-intestinal-injury-of-mass-casualties
#5
REVIEW
J F Lock, F Anger, C-T Germer
While intestinal injury is relatively rare in blunt abdominal trauma, it is common in penetrating abdominal trauma. Intestinal injury cannot be detected effectively by computed tomography (CT); therefore penetrating abdominal injury or abdominal signs in blunt trauma require liberal indications for explorative laparotomy. In mass casualty situations patients with hemodynamic instability and abdominal signs should be prioritized for surgery. Besides intra-abdominal hemorrhage the major issue is septic complications due to intestinal perforation...
August 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28827509/early-definitive-fracture-fixation-is-safely-performed-in-the-presence-of-an-open-abdomen-in-multiply-injured-patients
#6
Nina E Glass, Clay Cothren Burlew, Jens Hahnhaussen, Sebastian Weckbach, Fredric M Pieracci, Ernest E Moore, Philip F Stahel
OBJECTIVE: To investigate the safety and feasibility of performing definitive fracture fixation in multiply injured patients in the presence of an open abdomen after laparotomy. DESIGN: Retrospective observational cohort study. SETTING: Level-I academic trauma center. PATIENTS: Adult polytrauma patients with presence of an open abdomen after "damage control" laparotomy and associated major fractures of long bones, acetabulum, pelvis or spine, requiring surgical repair (n=81)...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28814969/the-role-of-open-abdomen-in-non-trauma-patient-wses-consensus-paper
#7
REVIEW
Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Ernest E Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M Abu-Zidan, Massimo Sartelli, Marc De Moya, George Velmahos, Gustavo Pereira Fraga, Bruno M Pereira, Ari Leppaniemi, Marja A Boermeester, Andrew W Kirkpatrick, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Ignacio Martin-Loeches, Michael Sugrue, Salomone Di Saverio, Ewen Griffiths, Kjetil Soreide, John E Mazuski, Addison K May, Philippe Montravers, Rita Maria Melotti, Michele Pisano, Francesco Salvetti, Gianmariano Marchesi, Tino M Valetti, Thomas Scalea, Osvaldo Chiara, Jeffry L Kashuk, Luca Ansaloni
The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28806285/peritoneal-cavity-lavage-reduces-the-presence-of-mitochondrial-damage-associated-molecular-patterns-in-open-abdomen-patients
#8
Patricia Angellice Martinez-Quinones, Cameron Grant McCarthy, Caleb J Mentzer, Camilla Ferreira Wenceslau, Steven Barry Holsten, R Clinton Webb, Keith O'Malley
BACKGROUND: Mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA and N-formylated peptides, are endogenous molecules released from tissue after traumatic injury. mtDAMPs are potent activators of the innate immune system. They have similarities with bacteria, which allow mtDAMPs to interact with the same pattern recognition receptors and mediate the development of Systemic Inflammatory Response Syndrome (SIRS). Current recommendations for management of an open abdomen include returning to the operating room every 48 hours for peritoneal cavity lavage until definitive procedure...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28780148/intraabdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#9
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal compartment syndrome (ACS) is the end point of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion in the abdomen (such as ascites or a hematoma) leads to pathologically increased pressure. This results in so-called intraabdominal hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28745787/short-term-and-long-term-effects-of-covered-stent-endovascular-graft-exclusion-for-the-treatment-of-abdominal-aortic-aneurysm-rupture
#10
L Li, Y-Q Li, B Liu, H Wang, D-M Zhang
OBJECTIVE: We studied short-term and long-term effects of covered stent endovascular graft exclusion for the treatment of abdominal aortic aneurysm rupture. PATIENTS AND METHODS: From January 2013 to January 2016, 88 patients with fractured abdominal aortic aneurysm were enrolled in this study. Patients were divided into the control group or the open abdomen group (n=52) and the observation group or the isolated group (n=36). Patients in the control group were treated with open abdominal aneurysm resection and artificial blood vessel transplant technique, while patients in the observation group were treated with percutaneous stent graft endovascular graft exclusion...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28732537/negative-pressure-wound-therapy-versus-modified-barker-vacuum-pack-as-temporary-abdominal-closure-technique-for-open-abdomen-management-a-four-year-experience
#11
Giulia Montori, Niccolò Allievi, Federico Coccolini, Leonardo Solaini, Luca Campanati, Marco Ceresoli, Paola Fugazzola, Roberto Manfredi, Stefano Magnone, Matteo Tomasoni, Luca Ansaloni
BACKGROUND: We reviewed our experience with patients presenting with trauma and peritonitis who underwent an open abdomen (OA) procedure, and compared outcomes between Negative Pressure Wound Therapy (NPWT) and a modified Barker Vacuum Pack (mBVP) technique. METHODS: In this descriptive study, we retrospectively analyzed data regarding all patients who underwent OA for intra-abdominal sepsis or abdominal trauma at our Centre from January 2012 to December 2015. Demographic data, co-morbidities, indications to surgery, intra-operative details and Björck classification grade were considered...
July 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28717912/management-of-the-open-abdomen-after-liver-transplantation
#12
Christian Hobeika, Marc-Antoine Allard, Petru-Octav Bucur, Salima Naili, Antonio Sa Cunha, Daniel Cherqui, Denis Castaing, René Adam, Eric Vibert
INTRODUCTION: The optimal management of the open abdomen (OA) after liver transplantation (LT) is unclear. The negative pressure wound therapy (NPWT) has been shown to be safe and can increase the chance for early fascial closure in trauma or septic patients. However, little data are available on the specific setting of LT. We aimed to report our experience of OA after LT, marked by the recent use of NPWT. METHODS: All patients with postponed wall closure after LT, from 2002 to 2014, in a single institution were included and retrospectively analyzed...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28661985/a-novel-approach-to-sealing-the-denuded-dermis-of-the-abdominal-wall-with-a-negative-pressure-wound-device-after-a-decompressive-laparotomy
#13
John Davis, Daniel M Caruso, Kevin N Foster, Marc R Matthews
The open abdomen is a well-known technique that is applied in a wide variety of clinical situations, including treatment of abdominal compartment syndrome, damage control laparotomy, and severe intraabdominal sepsis. Disease states such as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis or extensive deep partial and/or full-thickness torso burns involving the abdomen often result in a complete epidermal and partial dermal loss. When ABThera Open Abdomen Negative Pressure Wound Therapy is attempted in these patients, the exposed subcutaneous tissue rarely allows for an adequate seal between the adhesive barrier and the denuded skin...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28647198/trends-in-open-abdominal-exposure-among-vascular-surgery-trainees
#14
COMPARATIVE STUDY
Victoria Greenwood, Brian Shames, Adam Tanious, Murray L Shames, Jeffrey E Indes
BACKGROUND: This retrospective study evaluates the trends in open abdominal surgery cases among integrated vascular surgery residents compared with their 5 + 2 counterparts. METHODS: The Accreditation Council for Graduate Medical Education (ACGME) case logs between 2007 and 2016 were collected from a pool of 9861 residents and fellows from 371 institutions. Trainees were grouped into three categories: general surgery residency (GSR), integrated vascular surgery residency (IVSR), and vascular surgery fellowship in the United States...
September 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28578386/injectable-in-situ-cross-linking-chitosan-hyaluronic-acid-based-hydrogels-for-abdominal-tissue-regeneration
#15
Youming Deng, Jianan Ren, Guopu Chen, Guanwei Li, Xiuwen Wu, Gefei Wang, Guosheng Gu, Jieshou Li
Abdominal wall defect caused by open abdomen (OA) or abdominal trauma is a serious issue since it induces several clinical problems. Although a variety of prosthetic materials are commonly employed, complications occur including host soft tissue response, fistula formation and chronic patient discomfort. Recently, abundant natural polymers have been used for injectable hydrogel synthesis in tissue regeneration. In this study, we produced the chitosan - hyaluronic acid (CS/HA) hydrogel and investigated its effects on abdominal tissue regeneration...
June 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28536807/prognostic-factors-for-enteroatmospheric-fistula-in-open-abdomen-treated-with-negative-pressure-wound-therapy-a-multicentre-experience
#16
Guillaume Giudicelli, A Rossetti, C Scarpa, N C Buchs, R Hompes, R J Guy, K Ukegjini, P Morel, F Ris, M Adamina
BACKGROUND: Reductions in mortality were reported with negative pressure wound therapy for laparostomy. However, some authors have voiced concern over an increased risk of enteroatmospheric fistulae. In this retrospective study, we hypothesized that surgical and metabolic derangements could increase the incidence of enteroatmospheric fistulae. We aimed to assess our experience and report long-term outcomes. METHODS: A multicentre review of all patients with a laparostomy managed with negative pressure wound therapy between 2005 and 2015 was undertaken...
August 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28520603/does-negative-pressure-wound-therapy-for-the-open-abdomen-benefit-the-patient-a-retrospective-cohort-study
#17
Bojan Krebs, Tomaž Jagrič
OBJECTIVE: Negative-pressure wound therapy (NPWT) is the most modern and sophisticated method of temporary abdominal closure. The aim of the study was to determine the significant predictors for mortality in patients with NPWT. SETTING: University Clinical Centre Maribor, Slovenia MATERIALS AND METHODS:: The authors performed a retrospective cohort study of all patients treated with NPWT between January 1, 2011, and December 31, 2014. RESULTS: In the univariate analysis, the type of wound closure, more than 7 NPWT changes, the total days with NPWT, and time to wound closure were significantly associated with death of the patient...
June 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28502075/vacuum-assisted-wound-closure-and-mesh-mediated-fascial-traction-for-open-abdomen-therapy-a-systematic-review
#18
Stefan Acosta, Martin Björck, Ulf Petersson
BACKGROUND: The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. METHODS: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure"...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28502074/causes-and-consequences-of-mesenteric-embolization-after-endovascular-aorto-iliac-intervention-a-nested-case-control-study
#19
Stefan Acosta, Jussi Kärkkäinen
BACKGROUND: Causes and consequences of mesenteric embolization after endovascular aorto-iliac procedures have not been studied adequately. METHODS: Consecutive patients with mesenteric embolization after endovascular aorto-iliac intervention between 2011 and 2015 (case-group, n = 9) were investigated and compared with age, gender and procedure-matched random controls (n = 36). RESULTS: Compared to the control group, a higher proportion of patients with mesenteric embolization were current smokers (89% vs...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28489215/negative-pressure-therapy-for-the-treatment-of-complex-wounds
#20
Renan Victor Kümpel Schmidt Lima, Pedro Soler Coltro, Jayme Adriano Farina
The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
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