Current Therapy of the Open Abdominal Management Performed by General Surgeons in the Community Hospital
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 ou...
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| Published in | Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 33; no. 5; pp. 843 - 848 |
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| Main Authors | , , , , , |
| 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 | |
| Online Access | Get full text |
| ISSN | 1340-2242 1882-4781 |
| DOI | 10.11231/jaem.33.843 |
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| Abstract | 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. |
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| AbstractList | 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. 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. 要旨：ACSが広く認識されるなか，当院でもopen abdominal management（OAM）を行う機会が増えている。今回，2009年4月からの31ヵ月間に行われた重症外傷後のOAM 4例（平均25.8歳，男性75％）に関して当院での現状を検討した。当院でのOAMの特徴は，(1)silo closure＋持続吸引，(2)簡易縫縮法の2点である。全例が出血性ショックを伴う重症腹部外傷症例で，交通外傷が2例，高所墜落と重機横転による圧挫損傷が各1例であった。そのうち3例で来院同日にinterventional radiology（IVR）と止血術の両方を行った。Primary ACSと診断したのが1例，閉腹困難例が1例，Damage control surgeryを行ったのが2例だった。高所墜落例以外の3例は腹壁閉鎖でき30日生存例は2例だった。OAMは有用で一般外科医にとっても必要不可欠である。 |
| Author | Ishimine, Tomonari Kameyama, Shinichiro Sakamoto, Yuichiro Koami, Hiroyuki Matsumura, Toshinobu Isa, Tsutomu |
| Author_FL | 伊佐 勉 亀山 眞一郎 阪本 雄一郎 小網 博之 伊志嶺 朝成 松村 敏信 |
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| Author_xml | – sequence: 1 fullname: Sakamoto, Yuichiro organization: Department of Emergency Medicine, Saga University – sequence: 1 fullname: Matsumura, Toshinobu organization: Department of Surgery, Center for Gastroenterology, Urasoe General Hospital – sequence: 1 fullname: Koami, Hiroyuki organization: Department of Surgery, Center for Gastroenterology, Urasoe General Hospital – sequence: 1 fullname: Ishimine, Tomonari organization: Department of Surgery, Center for Gastroenterology, Urasoe General Hospital – sequence: 1 fullname: Isa, Tsutomu organization: Department of Surgery, Center for Gastroenterology, Urasoe General Hospital – sequence: 1 fullname: Kameyama, Shinichiro organization: Department of Surgery, Center for Gastroenterology, Urasoe General Hospital |
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| PublicationTitle_FL | J Abdom Emerg Med 日本腹部救急医学会雑誌 日腹部救急医会誌 Journal of Abdominal Emergency Medicine Nihon Fukubu Kyukyu Igakkai Zasshi |
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| References | 4) Fernandez L, Norwood S, Roettger R, et al: Temporary intravenous bag silo closure in severe abdominal trauma. J Trauma 1996; 40: 258-260. 7) 久志本成樹, 佐藤格夫, 増野智彦, ほか: 一期的閉腹不適応症例に対するenterocutaneous fistulaの予防と早期筋膜閉鎖のためのopen abdomenの管理法. 日腹部救急医会誌 2010; 30: 915-923. 11) Barker 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: 201-207. 13) Shah SK, Jimenez F, Letourneau PA, et al: Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome. Scand J Trauma Resusc Emerg Med 2012; 20: 25. 9) Garner GB, Ware DN, Cocanour CS, et al: Vacuum-assisted wound closure provides early fascial reapproximation in trauma patients with open abdomen. Am J Surg 2001; 182: 630-638. 1) 村山良太, 長嶺義哲, 伊志嶺朝成: Zipperつき人工腹壁被覆材（Ethizip®）を使用した4例. 日救急医会誌 2006; 17: 57-61. 3) World Society of the Abdominal Compartment Syndrome Resuscitation Algorithms. Available online at: http://www.wsacs.org. Accessed May 19, 2013. 6) 森脇義弘, 岩下眞之, 大井康史, ほか: Abdominal Compartment Syndromeに対するOpen Abdomen ManagementとVacuum Assisted Closure. ICUとCCU 2010; 34: 537-546. 5) Smith LA, Barker DE, Chase CW, et al: Vacuum pack technique of temporary abdominal closure: a four-year experience. Am Surg 1997; 63: 1102-1107. 8) Frazee RC, Abernathy SW, Jupiter DC, et al: The number of operations negatively influences fascia closure in open abdomen management. Am J Surg 2012; 204: 996-999. 12) Burlew CC: The open abdomen: practical implications for the practicing surgeon. Am J Surg 2012; 204: 826-835. 10) Miller PR, Thompson JT, Faler BJ, et al: Late fascial closure in lieu of ventral hernia. J Trauma 2002; 53: 843-849. 2) Malbrain MLNG, Cheatham ML, Kirkpatrick A, et al: Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med 2006; 32: 1722-1732. |
| References_xml | – reference: 6) 森脇義弘, 岩下眞之, 大井康史, ほか: Abdominal Compartment Syndromeに対するOpen Abdomen ManagementとVacuum Assisted Closure. ICUとCCU 2010; 34: 537-546. – reference: 7) 久志本成樹, 佐藤格夫, 増野智彦, ほか: 一期的閉腹不適応症例に対するenterocutaneous fistulaの予防と早期筋膜閉鎖のためのopen abdomenの管理法. 日腹部救急医会誌 2010; 30: 915-923. – reference: 3) World Society of the Abdominal Compartment Syndrome Resuscitation Algorithms. Available online at: http://www.wsacs.org. Accessed May 19, 2013. – reference: 8) Frazee RC, Abernathy SW, Jupiter DC, et al: The number of operations negatively influences fascia closure in open abdomen management. Am J Surg 2012; 204: 996-999. – reference: 9) Garner GB, Ware DN, Cocanour CS, et al: Vacuum-assisted wound closure provides early fascial reapproximation in trauma patients with open abdomen. Am J Surg 2001; 182: 630-638. – reference: 2) Malbrain MLNG, Cheatham ML, Kirkpatrick A, et al: Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intensive Care Med 2006; 32: 1722-1732. – reference: 12) Burlew CC: The open abdomen: practical implications for the practicing surgeon. Am J Surg 2012; 204: 826-835. – reference: 10) Miller PR, Thompson JT, Faler BJ, et al: Late fascial closure in lieu of ventral hernia. J Trauma 2002; 53: 843-849. – reference: 11) Barker 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: 201-207. – reference: 1) 村山良太, 長嶺義哲, 伊志嶺朝成: Zipperつき人工腹壁被覆材（Ethizip®）を使用した4例. 日救急医会誌 2006; 17: 57-61. – reference: 4) Fernandez L, Norwood S, Roettger R, et al: Temporary intravenous bag silo closure in severe abdominal trauma. J Trauma 1996; 40: 258-260. – reference: 5) Smith LA, Barker DE, Chase CW, et al: Vacuum pack technique of temporary abdominal closure: a four-year experience. Am Surg 1997; 63: 1102-1107. – reference: 13) Shah SK, Jimenez F, Letourneau PA, et al: Strategies for modulating the inflammatory response after decompression from abdominal compartment syndrome. Scand J Trauma Resusc Emerg Med 2012; 20: 25. |
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| Title | Current Therapy of the Open Abdominal Management Performed by General Surgeons in the Community Hospital |
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