Faculty Collaboration Database

Temporary abdominal closure (TAC) for planned relaparotomy (etappenlavage) in trauma. J Trauma 1990 Jun;30(6):719-23

Date

06/01/1990

Pubmed ID

2191142

DOI

10.1097/00005373-199006000-00011

Scopus ID

2-s2.0-0025330947 (requires institutional sign-in at Scopus site)   120 Citations

Abstract

Planned relaparotomy (temporary abdominal closure) was studied prospectively in 20 trauma patients. Four died in the first 24 hours from hypothermia, coagulopathy, shock (three), and septic shock (one). The 16 survivors had a Velcro-like prosthetic placed to facilitate abdominal closure and re-entry. Prosthetic was necessary in eight because bowel edema precluded fascial closure, and useful for removal of packing (three) and for the management of peritonitis (five). The prosthetic did not open spontaneously, nor was it associated with evisceration or bowel fistula. Temporary abdominal closure (TAC) permitted reappraisal and staged repair of intra-abdominal pathology, including bowel resection and anastomosis. TAC identified 14 problems early: bleeding (five), bile leaks (two), GI complications (six), liver necrosis (one). Five patients developed superficial wound infections, and three went on to develop fascial necrosis.

Author List

Aprahamian C, Wittmann DH, Bergstein JM, Quebbeman EJ

Author

Edward J. Quebbeman MD Emeritus Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdominal Injuries
Adult
Female
Humans
Injury Severity Score
Laparotomy
Male
Middle Aged
Prospective Studies
Prostheses and Implants
Reoperation
Surgical Wound Infection
Suture Techniques