Temporary closure of the abdominal cavity

Abstract

Evaluate the effectiveness of methods used by the temporary closure of the abdomen and bring our original method of closure. In the departments of surgery Simferopol we have developed an original method of the temporary closure of the abdominal cavity with the use of negative pressure. The key points are: 1. Shelter transparent perforated plastic film of the abdominal cavity after the main phase of the operation. This film completely separates the parietal peritoneum of the anterior abdominal wall from the internal organs, preventing the formation of adhesions adhesions. The distance between the defects in the film is about 5 cm, 0.5 cm defect dimensions; 2. The polyethylene film is laid on top of a sponge in the shape of an octopus. «Tentacles» reach octopus side channels, allowing to drain the pathological exudate is localized in the depth of the abdominal cavity; 3. Next, fit the other a sponge in the form of performing laparotomy wound edges without tension. In this sponge have channels for drainage, connected to the system of negative pressure; 4. A foam sponge laparotomic wounds and skin adhesive film is glued to seal the abdominal cavity. This design is advantageous because by its internal organs, discharge from the abdominal cavity measurable, implemented gradually medial traction edges of the anterior abdominal wall, the patient remains dry and clean, and requires minimal nursing care. The above procedure was used in 5 patients diagnosed with secondary peritonitis. The severity of the condition for admission system APACHE II score was 18-24. Final relaparotomy completed stratified tissue suturing. All the patients survived. A method of temporary closure of the abdominal cavity (modified VAC-system) has been successfully put into practice. Further research is needed in order to obtain reliable results of the study and improvement of methods.