Antecedentes: El abdomen abierto es un método quirúrgico utilizado en el tratamiento de pacientes con sepsis abdominal, en trauma abdominal en casos de cirugía de control de daños y en casos de síndrome de hipertensión abdominal. Objetivo: Demostrar la efectividad de una nueva técnica quirúrgica en pacientes con abdomen abierto. Método: Estudio de todos los pacientes manejados con abdomen abierto en nuestro hospital en un periodo de 5 años. Resultados: Se incluyeron 24 pacientes, 18 hombres y 6 mujeres, con una edad promedio de 41.5 ± 15.9 años. El diagnóstico operatorio fue síndrome compartimental abdominal en 7 (29%) casos, sepsis abdominal en 9 (38%) y trauma abdominal en 8 (33%). La puntuación APACHE II tuvo una mediana de 8 (rango: 5-21) y el SIRS una mediana de 2 (rango: 1-4). La mediana de ingresos a quirófano por paciente fue de dos. La mediana de las aproximaciones aponeuróticas fuera de quirófano fue de cuatro. Se realizó un cierre definitivo de la pared abdominal en 21 de 22 pacientes vivos, considerando cierre exitoso en el 95%. Conclusiones: El cierre secuencial es una técnica efectiva que ofrece una alternativa en pacientes que requieren manejo con abdomen abierto.
Background:The open abdomen is a surgical technique used in the treatment of patients with abdominal sepsis, abdominal trauma, and abdominal hypertension syndrome. Objective: The aim was to demonstrate the effectiveness of a new surgical technique designed for the management and closure of the abdominal wall in patients with open abdomen. Method: The study of all patients treated with open abdomen in our hospital over a 5-year period. Results: It were included 24 patients, 18 men and 6 women. The average age was 41.5 ± 15.9 years. Operative diagnosis was abdominal compartment syndrome in 7 (29%) cases, abdominal sepsis in 9 (38%), and abdominal trauma in 8 (33%). The median of APACHE II score was eight points (range: 5-21), while the assessment of SIRS score had a median of two points (range: 1-4). The median of surgical procedures performed in operating room was two per patient. The median of fascial surgical closures performed in the patient bed was four. A successful closure of the abdominal wall was performed in 21 of 22 live patients (95%). Conclusions: The sequential closure of the abdominal wall is an effective technique that offers an alternative to the management of the open abdomen.
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