腹部コンパートメント症候群に続発した閉創困難に対し創外固定具を使用した腹壁牽引が有用であった１例
症例は29歳，男性．工事現場での墜落による鉄骨支柱での会陰部杙創．鉄骨による仙骨骨折に伴う出血性ショックに対して緊急開腹止血術が行われ，持続陰圧吸引療法（Vaccum pack closure：以下VPC）を用いた開腹創管理（Open abdominal management：以下OAM）となった．術後，腸管浮腫の遷延および二次性の小腸穿孔を来し閉腹困難となった．最終的な閉創を目的として第19病日より整形外科用創外固定装置とVPCを併用した創管理を開始した．腹壁は連日，約２cmずつ近接してゆき，第27病日には腹壁が十分近接したため手術室にて定型的な閉腹が可能となった．OAM後の閉創困難症例に対...
Saved in:
| Published in | Journal of the Japanese Association for the Surgery of Trauma Vol. 29; no. 4; pp. 399 - 403 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本外傷学会
2015
The Japanese Association for the Surgery of Trauma |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1340-6264 2188-0190 |
| DOI | 10.11382/jjast.29.399 |
Cover
| Abstract | 症例は29歳，男性．工事現場での墜落による鉄骨支柱での会陰部杙創．鉄骨による仙骨骨折に伴う出血性ショックに対して緊急開腹止血術が行われ，持続陰圧吸引療法（Vaccum pack closure：以下VPC）を用いた開腹創管理（Open abdominal management：以下OAM）となった．術後，腸管浮腫の遷延および二次性の小腸穿孔を来し閉腹困難となった．最終的な閉創を目的として第19病日より整形外科用創外固定装置とVPCを併用した創管理を開始した．腹壁は連日，約２cmずつ近接してゆき，第27病日には腹壁が十分近接したため手術室にて定型的な閉腹が可能となった．OAM後の閉創困難症例に対する整形外科用創外固定装置による閉腹方法は，一つの選択肢として有用である． |
|---|---|
| AbstractList | 症例は29歳，男性．工事現場での墜落による鉄骨支柱での会陰部杙創．鉄骨による仙骨骨折に伴う出血性ショックに対して緊急開腹止血術が行われ，持続陰圧吸引療法（Vaccum pack closure：以下VPC）を用いた開腹創管理（Open abdominal management：以下OAM）となった．術後，腸管浮腫の遷延および二次性の小腸穿孔を来し閉腹困難となった．最終的な閉創を目的として第19病日より整形外科用創外固定装置とVPCを併用した創管理を開始した．腹壁は連日，約２cmずつ近接してゆき，第27病日には腹壁が十分近接したため手術室にて定型的な閉腹が可能となった．OAM後の閉創困難症例に対する整形外科用創外固定装置による閉腹方法は，一つの選択肢として有用である． A 29-year-old constructive worker fell onto a steel column and suffered an impalement injury to the perineal region. We performed urgent laparotomy for a hemorrhagic shock state. Laparotomy encountered massive bleeding from zone 3 of the peritoneum. Hemostasis was accomplished with gauze-packing. The abdominal wall remained open with handmade vacuum pack closure (VAC). During the open abdomen and damage control (OA/DC) strategy, prolonged edema of the bowel and small intestinal fistula made it impossible to close the abdomen primarily. On hospital day 19, we placed an orthopedic external fixation device at the open abdominal wall and approached with it by about 2 cm day by day. We successfully closed the abdomen after 8 days. An orthopedic external fixator was effective for the secondary abdominal fascial closure. 症例は29歳，男性．工事現場での墜落による鉄骨支柱での会陰部杙創．鉄骨による仙骨骨折に伴う出血性ショックに対して緊急開腹止血術が行われ，持続陰圧吸引療法（Vaccum pack closure：以下VPC）を用いた開腹創管理（Open abdominal management：以下OAM）となった．術後，腸管浮腫の遷延および二次性の小腸穿孔を来し閉腹困難となった．最終的な閉創を目的として第19病日より整形外科用創外固定装置とVPCを併用した創管理を開始した．腹壁は連日，約２cmずつ近接してゆき，第27病日には腹壁が十分近接したため手術室にて定型的な閉腹が可能となった．OAM後の閉創困難症例に対する整形外科用創外固定装置による閉腹方法は，一つの選択肢として有用である． |
| Author | 矢野, 秀朗 須田, 竜一郎 |
| Author_FL | YANO Hideaki SUDA Ryuichiro |
| Author_FL_xml | – sequence: 1 fullname: SUDA Ryuichiro – sequence: 2 fullname: YANO Hideaki |
| Author_xml | – sequence: 1 fullname: 矢野, 秀朗 organization: 国立国際医療研究センター外科 – sequence: 1 fullname: 須田, 竜一郎 organization: 国立国際医療研究センター外科 |
| BackLink | https://cir.nii.ac.jp/crid/1390001205515036032$$DView record in CiNii |
| BookMark | eNo9UMlKA0EQbUTBuBz9A68Te5mtTyLiBoIXPQ-dpEdn0CiZXLw5GcQEPaioIYkQREFBUEFUDEn8mLYdc_IX7CRiUVRR9V69gjcCBrPbWQ7ABIJJhIiNp3yfBfkkpklC6QBIYGTbGkQUDoIEIjrUTGzqw2A8CLwUNGydEsu2EuD4e_-9E92JwrOIVJ6IqCmiooiuemMxLh_IvUrcvhHhffxajSsNEZZFWO9clGTpRdaeOrVrBcnHttp3NzcXstaQD1W5_yYKp5-tj_jsrn-iHsnrMC61ZPNchEdfl6UedCvCggiVSP2nefLZPhwDQy7bDPj4Xx8Fa_Nzq7OL2vLKwtLszLLmY4KxplPOINGxbtJUBjKMLYRS2OLUdhlFpoEo4VhhKiyXWybjpulylrFcixGcsckomOzrZj3PSXvdigiFECIMDQMZkJiQYEWb7tP8IM_WubOT87ZYbtdhubyX3uROz3UHU0fvFmX9P5LeYDnHZ-QXgE6wOA |
| ContentType | Journal Article |
| Copyright | 2015 一般社団法人 日本外傷学会 |
| Copyright_xml | – notice: 2015 一般社団法人 日本外傷学会 |
| DBID | RYH |
| DOI | 10.11382/jjast.29.399 |
| DatabaseName | CiNii Complete |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| DocumentTitleAlternate | THE EFFECTIVENESS OF AN ORTHOPEDIC EXTERNAL FXATION DEVICE FOR SECONDARY ABDOMINAL FASCIAL CLOSURE IN OPEN ABDOMEN AND DAMAGE CONTROL STRATEGY : A CASE REPORT |
| DocumentTitle_FL | THE EFFECTIVENESS OF AN ORTHOPEDIC EXTERNAL FXATION DEVICE FOR SECONDARY ABDOMINAL FASCIAL CLOSURE IN OPEN ABDOMEN AND DAMAGE CONTROL STRATEGY : A CASE REPORT |
| EISSN | 2188-0190 |
| EndPage | 403 |
| ExternalDocumentID | 130005105234 article_jjast_29_4_29_399_article_char_ja |
| GroupedDBID | ALMA_UNASSIGNED_HOLDINGS JSF KQ8 RJT RYH |
| ID | FETCH-LOGICAL-j2322-49ea0342469bd0a22711b27e98fa9165193e269bbbb7fe76ae66fead7f7a32d83 |
| ISSN | 1340-6264 |
| IngestDate | Fri Jun 27 00:16:46 EDT 2025 Wed Sep 03 06:29:43 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2322-49ea0342469bd0a22711b27e98fa9165193e269bbbb7fe76ae66fead7f7a32d83 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjast/29/4/29_399/_article/-char/ja |
| PageCount | 5 |
| ParticipantIDs | nii_cinii_1390001205515036032 jstage_primary_article_jjast_29_4_29_399_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2015 |
| PublicationDateYYYYMMDD | 2015-01-01 |
| PublicationDate_xml | – year: 2015 text: 2015 |
| PublicationDecade | 2010 |
| PublicationTitle | Journal of the Japanese Association for the Surgery of Trauma |
| PublicationTitleAlternate | 日外傷会誌 |
| PublicationTitle_FL | 日本外傷学会雑誌 日外傷会誌 J. Jpn. Assoc. Surg. Trauma |
| PublicationYear | 2015 |
| Publisher | 一般社団法人 日本外傷学会 The Japanese Association for the Surgery of Trauma |
| Publisher_xml | – name: 一般社団法人 日本外傷学会 – name: The Japanese Association for the Surgery of Trauma |
| References | 4) Tremblay LN, Feliciano DV, Schmidt J, et al : Skin only or silo closure in the critically ill patient with an open abdomen. Am J Surg 2001 ; 182 : 670-675. 2) Kirkpatrick AW, Roberts DJ, De Waele J, et al : Intra-abdominal hypertension and the abdominal compartment syndrome : updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Medicine 2013 ; 39 : 1190-1206. 1) Quyn A, Johnston C, Hall D, et al : The open abdomen and temporary abdominal closure systems-historical evolution and systematic review. Colorectal Dis 2012 ; 14 : e429-438. 6) Koniaris LG, Hendrickson RJ, Drugas G, et al : Dynamic retention : a technique for closure of the complex abdomen in critically ill patients. Arch Surg 2001 ; 136 : 1359-1362. 8) Hirshowitz B, Lindenbaum E, Har-Shai Y : A skin-stretching device for the harnessing of the viscoelastic properties of skin. Plast Reconstr Surg 1993 ; 92 : 260-270. 7) Cohen BH, Cosmetto AJ : The suture tension adjustment reel. A new device for the management of skin closure. J Dermatol Surg Oncol 1992 ; 18 : 112-123. 5) Dubose JJ, Scalea TM, Holcomb JB : Open abdominal management after damage-control laparotomy for trauma : a prospective observational American Association for the Surgery of Trauma multicenter study. J Trauma Acute Care Surg 2013 ; 74 : 113-120. 3) Baker DE, Kaufman HJ, Smith LA, et al : Vacuum Pack Technique of Temporary Abdominal Closure : A 7-Year Experience with 112 Patients. J Trauma 2000 ; 48 : 201-206. |
| References_xml | – reference: 6) Koniaris LG, Hendrickson RJ, Drugas G, et al : Dynamic retention : a technique for closure of the complex abdomen in critically ill patients. Arch Surg 2001 ; 136 : 1359-1362. – reference: 5) Dubose JJ, Scalea TM, Holcomb JB : Open abdominal management after damage-control laparotomy for trauma : a prospective observational American Association for the Surgery of Trauma multicenter study. J Trauma Acute Care Surg 2013 ; 74 : 113-120. – reference: 7) Cohen BH, Cosmetto AJ : The suture tension adjustment reel. A new device for the management of skin closure. J Dermatol Surg Oncol 1992 ; 18 : 112-123. – reference: 1) Quyn A, Johnston C, Hall D, et al : The open abdomen and temporary abdominal closure systems-historical evolution and systematic review. Colorectal Dis 2012 ; 14 : e429-438. – reference: 3) Baker DE, Kaufman HJ, Smith LA, et al : Vacuum Pack Technique of Temporary Abdominal Closure : A 7-Year Experience with 112 Patients. J Trauma 2000 ; 48 : 201-206. – reference: 8) Hirshowitz B, Lindenbaum E, Har-Shai Y : A skin-stretching device for the harnessing of the viscoelastic properties of skin. Plast Reconstr Surg 1993 ; 92 : 260-270. – reference: 4) Tremblay LN, Feliciano DV, Schmidt J, et al : Skin only or silo closure in the critically ill patient with an open abdomen. Am J Surg 2001 ; 182 : 670-675. – reference: 2) Kirkpatrick AW, Roberts DJ, De Waele J, et al : Intra-abdominal hypertension and the abdominal compartment syndrome : updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Medicine 2013 ; 39 : 1190-1206. |
| SSID | ssib058493787 ssib002003913 ssib029852148 ssj0003306068 |
| Score | 1.9797679 |
| Snippet | 症例は29歳，男性．工事現場での墜落による鉄骨支柱での会陰部杙創．鉄骨による仙骨骨折に伴う出血性ショックに対して緊急開腹止血術が行われ，持続陰圧吸引療法（Vaccum pack closure：以下VPC）を用いた開腹創管理（Open abdominal... A 29-year-old constructive worker fell onto a steel column and suffered an impalement injury to the perineal region. We performed urgent laparotomy for a... |
| SourceID | nii jstage |
| SourceType | Publisher |
| StartPage | 399 |
| SubjectTerms | abdominal compartment syndrome Hoffmann Hoffmann II open abdomen 垂直牽引 腹部コンパートメント症候群 |
| Title | 腹部コンパートメント症候群に続発した閉創困難に対し創外固定具を使用した腹壁牽引が有用であった１例 |
| URI | https://www.jstage.jst.go.jp/article/jjast/29/4/29_399/_article/-char/ja https://cir.nii.ac.jp/crid/1390001205515036032 |
| Volume | 29 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本外傷学会雑誌, 2015/10/20, Vol.29(4), pp.399-403 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnR1NaxNBdGnrxYsoKlat9OCcSuLu7MfMHGfTDaWiIG2ht7DJbqA5VNH04sk0FBv0YEVb2gpFWrAgqCAqlrb-mO0ae_Iv-N7sJtmWih8hLNM372vem828N50PTbsufKviGxUjF0K0kLPKoZ_jFebnaMCqFegEVcfGDc63bjtjU9b4tD3dNzCRWbU0Vy_nKw9P3FfyP14FGPgVd8n-g2e7TAEAZfAvPMHD8PwrHxOPE24TVxBPEG4SyYlnEk6Ja6qC2SsIowMppAXO04I0jiNjFSOCEc6IZ6vFEAIhrkekpXAMIl0FcYiQClkQV6ZVQJgWiqiYcAgXig_g2FgQLnF1VeUSaWYY2kQWUUqPT4YKRAOrlFwqiKek28oILG27oMSziDtK3KJSzOqY5ZhiXdPZqAMAARlljSIErCTsFJmDxaCZBdWKowxlhyHITSFmRkRR8TGUPh7h7m8yAYz9xyFowctAs-9LdwnoRLJ3HXEhtpjrDaVoQ6l3_AVS9BEsgSlBXZTK0XlJ5-Bej4qhepKqGmi1l1Axhayamqxm7kwHJVth1aub4cpRriwoUtXAxDVoAQf7EhrQQk-5ckSxBTw75Y9kGY9il1XOlqNEOooMdJCZEdPE_SM0OYo-HyoYhI24QjK5B7YzzKYTWzPZOSQ1ZprJDVlp-GWpIy9OGNlNjkcF12r-g3qeinyX6shh6fjPWRxmbGpa_dopypiB63xv3snk1OpShO6gRAWHCLY3JwABOUTsac6C4ZwJSbWebKntNLVzVi-odCOrEESxNcjp8LCO_tmZmUygOnlWO5P2q2GZ_Fyc0_pq_nnt2Y-Fr4fN7Wj-Y9SE71LU3I2ai1Hztfpzsb3yOH602t7fihpv25_X2qs7UWMlamwcLrfi1qd4_cPh-iZUxe_3AY6QreV4fSd-txYvfInmnx_sfWu_2E5IQFC82Wi39uLdl1Hj6fdXLVX1JmrMRw1gsvFzd-lg_8kFbaroTRbGcullLLkaxQkrS4Q-HhdqOaIc6D6lzDDKlIWCV31IMTERDCnUwYdVQ-b4oeNUYZhiVeabNODmRW1g9u5seEkbDlig8yC0zTINIH8LfMgaqqwSCEhObYvRQY0nZizdS07cKaW_sCVl7BIVJQsfYPFuDe5RLdX8QW0IDF-qzOATkls10a5DVmhDpK6b9PIf6q9op_GlSuZYr2oD9ftz4RBkHfXyNdWLfgFA5wSk |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E8%85%B9%E9%83%A8%E3%82%B3%E3%83%B3%E3%83%91%E3%83%BC%E3%83%88%E3%83%A1%E3%83%B3%E3%83%88%E7%97%87%E5%80%99%E7%BE%A4%E3%81%AB%E7%B6%9A%E7%99%BA%E3%81%97%E3%81%9F%E9%96%89%E5%89%B5%E5%9B%B0%E9%9B%A3%E3%81%AB%E5%AF%BE%E3%81%97%E5%89%B5%E5%A4%96%E5%9B%BA%E5%AE%9A%E5%85%B7%E3%82%92%E4%BD%BF%E7%94%A8%E3%81%97%E3%81%9F%E8%85%B9%E5%A3%81%E7%89%BD%E5%BC%95%E3%81%8C%E6%9C%89%E7%94%A8%E3%81%A7%E3%81%82%E3%81%A3%E3%81%9F%EF%BC%91%E4%BE%8B&rft.jtitle=Journal+of+the+Japanese+Association+for+the+Surgery+of+Trauma&rft.au=%E9%A0%88%E7%94%B0+%E7%AB%9C%E4%B8%80%E9%83%8E&rft.au=%E7%9F%A2%E9%87%8E+%E7%A7%80%E6%9C%97&rft.date=2015&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%A4%96%E5%82%B7%E5%AD%A6%E4%BC%9A&rft.issn=1340-6264&rft.eissn=2188-0190&rft.volume=29&rft.issue=4&rft.spage=399&rft.epage=403&rft_id=info:doi/10.11382%2Fjjast.29.399&rft.externalDocID=130005105234 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1340-6264&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1340-6264&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1340-6264&client=summon |