Current Therapy of the Open Abdominal Management Performed by General Surgeons in the Community Hospital

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 33; no. 5; pp. 843 - 848
• Main Authors: Sakamoto, Yuichiro, Matsumura, Toshinobu, Koami, Hiroyuki, Ishimine, Tomonari, Isa, Tsutomu, Kameyama, Shinichiro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 31.07.2013; 日本腹部救急医学会
• Subjects: abdominal compartment syndrome; open abdominal management; silo closure; 一般外科医
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.33.843

We have had several opportunities to perform open abdominal management (OAM) at the Urasoe General Hospital. We evaluated the data of 4 of our consecutive severe trauma cases (mean age 25.8 years; male 75%) who received OAM between April 2009 and October 2011. The major characteristic features of our OAM were “silo closure with a continuous suction system” and the “simple pulling-up method”. All patients were diagnosed as having severe abdominal trauma with hemorrhagic shock, the trauma sustained in a motor vehicle accident in 2 cases, by fall from a height in 1 case, and by crush injury in 1 case. Emergent operation as well as interventional radiology (IVR) was performed in 3 patients. The indications for OAM were primary ACS (1 case), difficulty in wound closure (1 case), and damage control surgery (2 cases). It was possible to close the abdominal fascia in 3 patients, and 2 of the patients were still surviving at 30 days. OAM is available method feasible for general surgeons, moreover, it is often necessary to undertake OAM to prevent ACS.