A prospective, randomised, controlled, double-blind phase I-II clinical trial on the safety of A-Part Gel as adhesion prophylaxis after major abdominal surgery versus non-treated group.
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Decompressive laparotomy with temporary abdominal closure versus percutaneous puncture with placement of abdominal catheter in patients with abdominal compartment syndrome during acute pancreatitis: background and design of multicenter, randomised, controlled study.
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Review of abdominal damage control and open abdomens: focus on gastrointestinal complications.
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Massive trauma and abdominal catastrophes carry high morbidity and mortality. In addition to the primary pathologic process, a secondary systemic injury, characterized by inflammatory mediator release, contributes to subsequent cellular, end-organ, and systemic dysfunction. These processes, in conjunction with large-volume resuscitations and tissue hypoperfusion, lead to acidosis, coagulopathy, and hypothermia. This "lethal triad" synergistically contributes to further physiologic derangements and, if uncorrected, may result in patient death. One manifestation of the associated clinical syndrome is the development of intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS). The development of ACS is insidious. If not recognized and treated promptly, ACS leads to multi-system organ failure (MSOF) and mortality. Improved understanding of IAH and ACS led to the development of damage control (DC)/open abdomen (OA) as surgical decompressive strategy. The DC/OA approach consists of three basic management steps. During the initial step the abdomen is opened, hemorrhage/abdominal contamination are controlled, and temporary abdominal closure is performed (Stage I). The patient then enters Stage II - physiologic restoration with core rewarming, correction of coagulopathy and completion of acute resuscitation. After physiologic normalization, definitive management of injuries and eventual abdominal closure (Stage III) are achieved. The authors will provide an overview of the DC/OA approach, as well as the clinical diagnosis of ACS, followed by a discussion of DC/OA-associated complications, with focus on digestive system-specific complaints. (+info)
Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines.
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Evaluation of the safety and efficacy of MonoMax(R) suture material for abdominal wall closure after primary midline laparotomy-a controlled prospective multicentre trial: ISSAAC [NCT005725079].
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