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Delayed open abdomen closure using a combination of acellular dermal matrix and skin graft in Korea: a case report

  • Yoonseob Kim (Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine) ;
  • Tae Ah Kim (Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine) ;
  • Hyung Min Hahn (Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine) ;
  • Byung Hee Kang (Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine)
  • 투고 : 2022.05.03
  • 심사 : 2022.09.06
  • 발행 : 2023.06.30

초록

Delayed closure of an open abdomen (OA) is a clinically challenging task despite its various modalities. It is substantially more difficult when the duration of OA treatment is prolonged due to a patient's condition. We introduced the management of a patient who had a delayed OA treatment spanning approximately 3 months due to severe abdominal contamination. The 64-year-old male patient had an injured pelvis pressed by a road roller. After visiting a trauma center, the patient initially underwent damage control surgery and OA management; however, early primary abdominal closure failed due to severe peritonitis. After negative pressure wound therapy for several months, an acellular dermal matrix graft followed by a skin graft were successfully used as treatments. A combination of acellular dermal matrix graft, negative pressure wound therapy, and skin graft techniques is a considerable management sequence for patients subjected to delayed OA treatment.

키워드

참고문헌

  1. Coccolini F, Roberts D, Ansaloni L, et al. The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg 2018;13:7.
  2. Regner JL, Kobayashi L, Coimbra R. Surgical strategies for management of the open abdomen. World J Surg 2012;36:497-510. https://doi.org/10.1007/s00268-011-1203-7
  3. Chen Y, Ye J, Song W, Chen J, Yuan Y, Ren J. Comparison of outcomes between early fascial closure and delayed abdominal closure in patients with open abdomen: a systematic review and meta-analysis. Gastroenterol Res Pract 2014;2014:784056.
  4. Nagashima F, Inoue S. A feasible operative treatment strategy for trauma patient with difficulties in closing the abdomen during open abdomen management (OAM) following damage control surgery-secondary publication. J Acute Care Surg 2020;10:83-9. https://doi.org/10.17479/jacs.2020.10.3.83
  5. Yetisir F, Sarer AE, Acar HZ, Aygar M. Delayed closure of 61 open abdomen patients based on an algorithm. Indian J Surg 2017;79:38-44. https://doi.org/10.1007/s12262-015-1422-5
  6. Heller L, McNichols CH, Ramirez OM. Component separations. Semin Plast Surg 2012;26:25-8. https://doi.org/10.1055/s-0032-1302462
  7. Chiara O, Cimbanassi S, Biffl W, et al. International consensus conference on open abdomen in trauma. J Trauma Acute Care Surg 2016;80:173-83. https://doi.org/10.1097/TA.0000000000000882
  8. Sartelli M, Coccolini F, van Ramshorst GH, et al. WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg 2013;8:50.
  9. Capobianco CM, Zgonis T. An overview of negative pressure wound therapy for the lower extremity. Clin Podiatr Med Surg 2009;26:619-31. https://doi.org/10.1016/j.cpm.2009.08.002
  10. Jones DA, Neves Filho WV, Guimaraes JS, Castro DA, Ferracini AM. The use of negative pressure wound therapy in the treatment of infected wounds. Case studies. Rev Bras Ortop 2016;51:646-51. https://doi.org/10.1016/j.rbo.2016.04.002
  11. Boele van Hensbroek P, Wind J, Dijkgraaf MG, Busch OR, Goslings JC. Temporary closure of the open abdomen: a systematic review on delayed primary fascial closure in patients with an open abdomen. World J Surg 2009;33:199-207. https://doi.org/10.1007/s00268-008-9867-3
  12. Silverman RP. Acellular dermal matrix in abdominal wall reconstruction. Aesthet Surg J 2011;31(7 Suppl):24S-9S. https://doi.org/10.1177/1090820X11418090
  13. Caviggioli F, Klinger FM, Lisa A, et al. Matching biological mesh and negative pressure wound therapy in reconstructing an open abdomen defect. Case Rep Med 2014;2014:235930.