Document Detail


Evaluation of prosthetic mesh closure in semiopen-abdomen patients.
MedLine Citation:
PMID:  12209301     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To avoid the adverse consequences of abdominal compartment syndrome and to reduce the high mortality the celiotomy wound in patients with abdominal sepsis was closed without tension using prosthetic mesh. This produces a semiopen situation that permits staged reinterventions together with the functional reconstitution of the continuity of the abdominal wall. MATERIAL AND METHODS: Twenty-five patients with intra-abdominal sepsis of various causes were evaluated retrospectively to assess the results of semiopen management of the septic abdomen and reoperations on demand in severe peritonitis. All of the patients were in a state of neglected peritonitis, and had at least one failing organ system. The Mannheim Peritonitis Index (MPI) scoring system was used for stratification of abdominal sepsis. RESULTS: The mean MPI score of 25 patients was 24, ranging 10 to 33. Eight (32%) patients were reexplored (MPI=21). There were overall 9 (36%) complications in patients with mean MPI score of 23. Six (24%) mesh-related complications (infection and enterocutaneous fistulas) developed (MPI=19). The mean MPI score of patients without complications was 24. Four (16%) patients died with index MPI score of 26 due to fulminant hepatitis, myocardial infarction, and multiple organ failure. The admission period averaged 63 days. CONCLUSIONS: In 25 critically ill patients with abdominal sepsis the mortality was lower than expected, relative to heterogeneous data from the literature; also, major complications occurred less frequently although the mean MPI score was high. The authors conclude that this approach is a reliable contribution to the complex treatment of these patients.
Authors:
S Sökmen; K Atila; S Bora; H Astarcioğlu; A Coker; M Füzün
Publication Detail:
Type:  Journal Article     Date:  2002-07-23
Journal Detail:
Title:  Hernia : the journal of hernias and abdominal wall surgery     Volume:  6     ISSN:  1265-4906     ISO Abbreviation:  Hernia     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-04     Completed Date:  2002-12-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9715168     Medline TA:  Hernia     Country:  France    
Other Details:
Languages:  eng     Pagination:  124-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey. selman. sokmen@deu. edu. tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical / adverse effects
Female
Gastrointestinal Diseases / etiology*,  surgery*
Humans
Intensive Care
Laparotomy / methods*,  mortality
Male
Middle Aged
Pancreatitis, Acute Necrotizing / complications,  surgery
Peritonitis / etiology*,  surgery*
Reoperation
Retrospective Studies
Rupture, Spontaneous / complications
Severity of Illness Index
Surgical Mesh*
Suture Techniques*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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