Summary
The authors report a new technique for secondary abdominal closure after burst abdomen
as illustrated by the case of a patient who developed a perforated sigmoid diverticulitis
following septic polyarthritis. Sigmoid resection was followed on the sixth day postoperative
by a burst abdomen. Upon abdominal revision the burst abdomen was found to be caused
by necrotic destruction of the linea alba. Abdominal wall closure was achieved using
the novel technique of inverting bilateral interrupted figure-of-eight suture of the
anterior and posterior rectus sheaths in combination with relieving lateral incisions
and mesh implantation in the sublay technique. It remains for future studies to show
whether this technique can reduce the high incisional hernia rate following secondary
abdominal wall closure.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Die infizierte Bauchdecke und der Platzbauch.Chirurg. 2000; 71: 754-762
- Faszienheilungsmöglichkeiten und Platzbauch.Chirurg. 2004; 755: 477-483
- A biomechanical study of suture pullout in linea alba.Surgery. 1989; 106: 888-892
- Abdominal incisions.in: Zuidema G.D. Yeo C.J. 5th ed. Shackelford's surgery of the alimentary tract. vol. II. WB Sounders Co, Philadelphia2002: 296
- Mechanical factors in abdominal wound closure: the prevention of fascial dehiscence.Surgery. 1985; 97: 631-639
- The burst abdominal wound: a mechanical approach.Br J Surg. 1976; 63: 873-876
- Theorie und Praxis der fortlaufenden Laparotomienaht (Platzbauch und Narbenhernie).Chirurg. 1988; 59: 654-660
- Collagen fibers in Linea alba and rectus sheaths. II – variability and biomechanical aspects.J Surg Res. 2001; 96: 239-245
- Collagen fibers in linea alba and rectus sheaths. I – General scheme and morphological aspects.J Surg Res. 2001; 96: 127-134
- Incidence of incisional hernia after dehiscence of the abdominal wound.Am J Surg. 1976; 131: 210-212
- Closure of burst abdomen after major gastrointestinal operations – comparison of different surgical techniques and later development of incisional hernia.Eur J Surg. 1999; 165: 958-961
- Temporary abdominal closure followed by definitive abdominal wall reconstruction of the open abdomen.Am J Surg. 2004; 188: 301-306
- The separation of anatomic components technique for the reconstruction of massive midline abdominal wall defects: anatomy, surgical technique, applications, and limitations revisited.Plast Reconstr Surg. 2000; 105: 731-738
- ‘Component separation’ method for closure of abdominal-wall defects: an anatomic and clinical study.Plast Reconstr Surg. 1990; 86: 519-526
- A technique for repairing massive ventral incisional hernias without the use of a mesh.Br J Plast Surg. 1999; 52: 399-403
- Elective colonic operation and prosthetic repair of incisional hernias: does contamination contraindicate abdominal wall prosthesis use?.J Am Coll Surg. 2000; 191: 366-372
Article info
Publication history
Published online: January 22, 2007
Accepted:
November 19,
2005
Received:
June 7,
2005
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
