Open Management of Septic Abdomen by Marlex Mesh Zipper

Bose, Smarajit; Kalra, Manju; Sandhu, Nav Parkash

doi:10.1111/j.1445-2197.1991.tb00240.x

Cited by 14 publications

(14 citation statements)

References 5 publications

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“…Eight series described peritonitis patients only [6, 7, 12, 19, 20, 35, 45, 54], and three described vascular patients only [16, 18, 42]. The remaining 11 series described general surgical, peritonitis, pancreatitis, and vascular patients [1, 3, 4, 18, 21, 30, 31, 41, 46, 52, 53].…”

Section: Resultsmentioning

confidence: 99%

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Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

et al. 2008

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BackgroundThis study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure after laparotomy. This “open abdomen” must then be temporarily closed. However, the FC rate varies between techniques.MethodsThe Cochrane Register of Controlled Trials, MEDLINE, and EMBASE databases were searched until December 2007. References were checked for additional studies. Search criteria included (synonyms of) “open abdomen,” “fascial closure,” “vacuum,” “reapproximation,” and “ventral hernia.” Open abdomen was defined as “the inability to close the abdominal fascia after laparotomy.” Two reviewers independently extracted data from original articles by using a predefined checklist.ResultsThe search identified 154 abstracts of which 96 were considered relevant. No comparative studies were identified. After reading them, 51 articles, including 57 case series were included. The techniques described were vacuum-assisted closure (VAC; 8 series), vacuum pack (15 series), artificial burr (4 series), Mesh/sheet (16 series), zipper (7 series), silo (3 series), skin closure (2 series), dynamic retention sutures (DRS), and loose packing (1 series each). The highest FC rates were seen in the artificial burr (90%), DRS (85%), and VAC (60%). The lowest mortality rates were seen in the artificial burr (17%), VAC (18%), and DRS (23%).ConclusionsThese results suggest that the artificial burr and the VAC are associated with the highest FC rates and the lowest mortality rates.

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Section: Resultsmentioning

confidence: 99%

“…Sixteen series described meshes or sheets (Table 4) [8, 9, 11, 16, 23, 27, 32, 35, 36, 39, 42, 43, 49, 50, 54, 55]. Zippers were used in seven series (Table 4) [4, 6, 19, 30, 31, 45, 52]. The silo was used in three series [2, 7, 11], and skin only in two series [9, 11].…”

Section: Resultsmentioning

confidence: 99%

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

et al. 2008

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“…After the literature review, 12 articles were selected 16,[18][19][20][21][22][23][24][25][26][27][28] (Table 2).…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

Utiyama

Pflug

Damous

et al. 2015

Rev. Col. Bras. Cir.

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OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years); 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

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“…The use of the zipper allows regular cleansing of the peritoneal cavity, gentle lysis of adhesions to permit access to loculations, and early detection and management of complications. Reports from other institutions in the literature worldwide have shown that the use of zippers facilitated reexploration, reducing operative time and allowing the performance of the procedure in the intensive care unit 1,10,12,14. The experience in our institution in the use of abdominal zippers for abdominal wall closure has been limited to the management of peripancreatic sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported on the use of abdominal zippers, including Stone and Strom in 1984,13 who demonstrated the advantages of utilizing zipper closure of the abdomen in gross peripancreatic sepsis treated by sequential laparotomy. Others have encouraged zipper use, not only in severe intraabdominal infections but also in patients with questionable bowel viability, and for damage control in trauma 5,14,15…”

Section: Introductionmentioning

confidence: 99%

Abdominal zippers for temporary abdominal closure in planned relaparotomies for peripancreatic sepsis: experience in a developing country

Perez

2001

J Hep Bil Pancr Surg

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Open Management of Septic Abdomen by Marlex Mesh Zipper

Cited by 14 publications

References 5 publications

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

Abdominal zippers for temporary abdominal closure in planned relaparotomies for peripancreatic sepsis: experience in a developing country

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